6533b857fe1ef96bd12b4518
RESEARCH PRODUCT
The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)
Tropea SaveriaDel Fiore PaoloMaurichi AndreaPatuzzo RobertoSantinami MarioRibero SimoneQuaglino PietroCaliendo VirginiaBorgognoni LorenzoSestini SerenaGiudice GiuseppeNacchiero EleonoraCaracò CorradoCordova AdrianaSolari NicolaPiazzalunga DarioTauceri FrancescaCarcoforo PaoloLombardo MaurizioCavallari SaraMocellin SimoneRiberti Carlosubject
OncologyMaleTreatment of cutaneous melanomamedicine.medical_specialtyCompletion lymph node dissectionSkin NeoplasmsCLND; Completion lymph node dissection; Melanoma; Metastatic melanoma in the sentinel nodes; Nomogram; Overall survival; Prognostic factors; Risk stratification; Treatment of cutaneous melanoma; Tumor burden; Humans; Lymph Node Excision; Lymphatic Metastasis; Male; Prognosis; Retrospective Studies; Sentinel Lymph Node Biopsy; Tumor Burden; Lymphadenopathy; Melanoma; Sentinel Lymph Node; Skin NeoplasmsTumor burdenSettore MED/19 - Chirurgia PlasticaLymphadenopathyPrognostic factorsNomogramInternal medicineBiopsymedicineMetastatic melanoma in the sentinel nodesHumansCLNDOverall survivalMelanomaCLND; Completion lymph node dissection; Melanoma; Metastatic melanoma in the sentinel nodes; Nomogram; Overall survival; Prognostic factors; Risk stratification; Treatment of cutaneous melanoma; Tumor burdenRisk stratificationRetrospective Studiesmedicine.diagnostic_testbusiness.industrySentinel Lymph Node BiopsyMelanomaTumor burdenSentinel nodemedicine.diseasePrognosisLymphatic MetastasisLymph Node ExcisionSentinel Lymph Nodebusinessdescription
Abstract Background: The management of melanoma patients with metastatic sentinel nodes (SN) is evolving based on the results of trials questioning the impact of completion lymph node dissection (CLND) and demonstrating the efficacy of new adjuvant treatments. In this landscape, new prognostic tools for fine risk stratification are eagerly sought to optimize the therapeutic path of these patients. Methods: A retrospective cohort of 2,086 patients treated with CLND after a positive SN biopsy in thirteen Italian Melanoma Centers was reviewed. Overall survival (OS) was the outcome of interest; included independent variables were the following: age, gender, primary melanoma site, Breslow thickness, ulceration, sentinel node tumor burden (SNTB), number of positive SN, non-sentinel lymph nodes (NSN) status. Univariate and multivariate survival analyses were performed using the Cox proportional hazard regression model. Results: The 3-year, 5-year and 10-year OS rates were 79 %, 70% and 54%, respectively. At univariate analysis, all variables, except for primary melanoma body site, were found to be statistically significant prognostic factors. Multivariate Cox regression analysis indicated that older age (P< 0.0001), male gender (P= 0.04), increasing Breslow thickness (P <0.0001), presence of ulceration (P =0.004), SNTB size (P <0.0001) and metastatic NSN (P <0.0001) were independent negative predictors of OS. Conclusion: The above results were utilized to build a nomogram in order to ease the practical implementation of our prognostic model, which might improve treatment personalization.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2022-01-01 |