Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study |
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| Authors: | Antonio Tejera‐Vaquerizo Simone Ribero Susana Puig David Moreno‐Ramírez Miguel A. Descalzo‐Gallego María T. Fierro Pietro Quaglino Cristina Carrera Josep Malvehy Sergi Vidal‐Sicart Antoni Bennássar Ramón Rull Llucìa Alos Celia Requena Isidro Bolumar Víctor Traves Ángel Pla María T. Fernández‐Figueras Carlos Ferrándiz Iciar Pascual José L. Manzano Marina Sánchez‐Lucas Pol Giménez‐Xavier Lara Ferrandiz Eduardo Nagore |
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| Affiliation: | 1. Dermatology Department, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, SpainA.B. and A.T.‐V. contributed equally to this work.;2. Medical Sciences Department, Section of Dermatology, University of Turin, Italy;3. Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain;4. Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain;5. Melanoma Unit, Medical‐&‐Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain;6. Unidad de Investigación, Fundación Piel Sana, Academia Espa?ola de Dermatología, Madrid, Spain;7. Nuclear Medicine Department, Hospital Clinic Barcelona, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain;8. Surgery Department, Hospital Clinic, Barcelona, Spain;9. Pathology Department, Hospital Clinic, Universidad de Barcelona, Barcelona, Spain;10. Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain;11. Surgery Department, Instituto Valenciano de Oncología, Valencia, Spain;12. Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain;13. Otorhinolaringology Department, Instituto Valenciano de Oncología, Valencia, Spain;14. Pathology Department, Hospital Universitari Germans Trial i Pujol, Badalona, Spain;15. Dermatology Department, Hospital Universitari Germans Trial i Pujol, Badalona, Universitat Autònoma de Barcelona, Spain;16. Surgery Department, Hospital Universitari Germans Trial i Pujol, Badalona, Spain;17. Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trial i Pujol, Badalona, Spain;18. Grupo de Investigación, Unidad de Gestión Clínica de Dermatología Médico‐Quirúrgica, Hospital Universitario Virgen Macarena, Sevilla, Spain |
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| Abstract: | The clinical value of sentinel lymph node (SLN) biopsy in thick melanoma patients (Breslow >4 mm) has not been sufficiently studied. The aim of the study is to evaluate whether SLN biopsy increases survival in patients with thick cutaneous melanoma, and, as a secondary objective, to investigate correlations between survival and lymph node status. We included 1,211 consecutive patients with thick melanomas (>4 mm) registered in the participating hospitals' melanoma databases between 1997 and 2015. Median follow‐up was 40 months. Of these patients, 752 were matched into pairs by propensity scores based on sex, age, tumor location, histologic features of melanoma, year of diagnosis, hospital and adjuvant interferon therapy. The SLN biopsy vs. observation was associated with better DFS [adjusted hazard ratio (AHR), 0.74; 95% confidence interval (CI) 0.61–0.90); p = 0.002] and OS (AHR, 0.75; 95% CI, 0.60–0.94; p = 0.013) but not MSS (AHR, 0.84; 95% CI, 0.65–1.08; p = 0.165). SLN‐negative patients had better 5‐ and 10‐year MSS compared with SLN‐positive patients (65.4 vs. 51.9% and 48.3 vs. 38.8%; p = 0.01, respectively). As a conclusion, SLN biopsy was associated with better DFS but not MSS in thick melanoma patients after adjustment for classic prognostic factors. SLN biopsy is useful for stratifying these patients into different prognostic groups. |
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| Keywords: | melanoma sentinel lymph node biopsy prognosis propensity score |
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