Sentinel node status predicts survival in thick melanomas: The Oxford perspective

Rughani, Milap G.; Swan, Marc C.; Adams, Titus S.; Marshall, Andrea; Asher, Ruth; Cassell, Oliver; Middleton, Mark R.

doi:10.1016/j.ejso.2012.04.011

Cited by 23 publications

(20 citation statements)

References 18 publications

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“…[16][17][18] In contrast, multiple other studies have demonstrated a predictive value for SNB in thick melanoma. [19][20][21][22][23][24] The therapeutic value of SNB for thick melanoma is also unclear. To better understand the clinical utility of SNB in thick melanoma, we reviewed data from the Surveillance Epidemiology and End Results (SEER) tumor registry, comparing patients who underwent SNB versus nodal observation.…”

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confidence: 98%

Sentinel lymph node biopsy is prognostic but not therapeutic for thick melanoma

Kachare

Singla

Vohra

et al. 2015

Surgery

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confidence: 98%

Sentinel lymph node biopsy is prognostic but not therapeutic for thick melanoma

Kachare

Singla

Vohra

et al. 2015

Surgery

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“…SLNB positivity is associated with several clinicopathologic characteristics, such as Breslow thickness, mitosis, and the presence of ulceration 11–13. The risk for recurrent disease is associated with this SLNB status, resulting in higher recurrence rates of up to 47 % in SLNB-positive patients and lower recurrence rates of 24 % in SLNB-negative patients 14–17.…”

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confidence: 99%

Nodular Histologic Subtype and Ulceration are Tumor Factors Associated with High Risk of Recurrence in Sentinel Node-Negative Melanoma Patients

et al. 2016

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BackgroundSince its introduction, the sentinel lymph node biopsy (SLNB) has become the standard staging procedure in clinical node-negative melanoma patients. A negative SLNB, however, does not guarantee a recurrence-free survival. Insight into metastatic patterns and risk factors for recurrence in SLNB negative melanoma patients can provide patient tailored guidelines.MethodsData concerning melanoma patients who underwent SLNB between 1996 and 2015 in a single center were prospectively collected. Cox regression analyses were used to determine variables associated with overall recurrence and distant first site of recurrence in SLNB-negative patients.ResultsIn 668 patients, SLNBs were performed between 1996 and 2015. Of these patients, 50.4 % were male and 49.6 % female with a median age of 55.2 (range 5.7–88.8) years. Median Breslow thickness was 2.2 (range 0.3–20) mm. The SLNB was positive in 27.8 % of patients. Recurrence rates were 53.2 % in SLNB-positive and 17.9 % in SLNB-negative patients (p < 0.001). For SLNB-negative patients, the site of first recurrence was distant in 58.5 %. Melanoma located in the head and neck region (hazard ratio 4.88, p = 0.003) and increasing Breslow thickness (hazard ratio 1.15, p = 0.013) were predictive for distant first site of recurrence in SLNB-negative patients. SLNB-negative patients with a nodular melanoma and ulceration had a recurrence rate of 43.1 %; the site of recurrence was distant in 64 % of these patients.ConclusionsThe recurrence rates of SLNB-negative nodular ulcerative melanoma patients approach those of SLNB-positive patients. Stringent follow-up is recommended in this subset of patients.

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“…This stratification may create some concerns when comparing different studies. We should point out that several authors [4][5][6][7][8][9][10][11][12] stated that sentinel lymph node status predicts DFS as well as OS in patients with thick melanoma.…”

Section: Discussionmentioning

confidence: 99%

“…Fairbairn et al achieved similar results in their study. 3 Several other authors [4][5][6][7][8][9][10][11][12] have been successful in correlating the SNB--based staging with improved DFS and OS, advocating its use in this subset of patients. The results presented by Vermeeren et al 13 suggest that the only relevant prognostic factor regarding patients with thick melanoma is SNB and this procedure can be used to stratify patients according to the risk of recurrence.…”

Section: Introductionmentioning

confidence: 99%

Biópsia do Gânglio Sentinela em Melanomas Espessos: Estudo Clínico Retrospectivo num Único Centro

Lemos

Vieira

Brinca

et al. 2016

SPDV

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RESUMO -Introdução:A biopsia do gânglio sentinela é um procedimento genericamente aceite no estdiamento do melanoma. O valor prognóstico desta técnica parece ser mais relevante nos melanomas de espessura intermédia (1-4mm) do que nos melanomas espessos (>4mm). Objectivo: Avaliar o valor prognóstico do estado do gânglio sentinela em doentes com melanoma espesso. Doentes e Métodos: A sobrevivência livre de doença e a sobrevivência global foram estimadas pelo método de Kaplan-Meier e por um modelo de regressão de Cox numa amostra de doentes com melanoma espesso. Resultados: Foram incluídos 43 doentes (52.2% do sexo masculino) com uma média etária de 63,9 anos. A biopsia do gânglio sentinela foi positiva em 20 casos (46,5%). O tempo médio de seguimento foi de 40 meses. Os doentes em que não foram encontradas metástases no gânglio sentinela tiveram uma sobrevivência livre de doença aos 5 anos significativamente maior do que o grupo de doentes com gânglio sentinela positivo (63% versus 19%, p<0.05). A sobrevivência global aos 5 anos foi tendencialmente mais baixa em doentes com gânglio sentinela positivo (52% versus 79%), embora sem significado estatístico. Conclusão: O estado do gânglio sentinela não teve influência estatística na sobrevivência global dos doentes da nossa série de melanomas espessos, provavelmente devido ao risco elevado de metastização por via hemática. Porém, a biopsia do gânglio sentinela forneceu informação prognóstica relevante, uma vez que teve clara influência na sobrevivência livre de doença. PALAVRAS-CHAVE -Biópsia do Gânglio Sentinela; Melanoma; Neoplasias da Pele; Prognóstico; Taxa de Sobrevida. Sentinel Lymph Node Biopsy in Thick Melanoma

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Sentinel node status predicts survival in thick melanomas: The Oxford perspective

Cited by 23 publications

References 18 publications

Sentinel lymph node biopsy is prognostic but not therapeutic for thick melanoma

Sentinel lymph node biopsy is prognostic but not therapeutic for thick melanoma

Nodular Histologic Subtype and Ulceration are Tumor Factors Associated with High Risk of Recurrence in Sentinel Node-Negative Melanoma Patients

Biópsia do Gânglio Sentinela em Melanomas Espessos: Estudo Clínico Retrospectivo num Único Centro

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