Ulrike Leiter1, Thomas K Eigentler2, Hans-Martin Häfner2, Michael Krimmel3, Ugur Uslu4, Ulrike Keim2, Benjamin Weide2, Helmut Breuninger2, Peter Martus5, Claus Garbe2. 1. Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany. ulrike.leiter@med.uni-tuebingen.de. 2. Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany. 3. Department of Oral and Maxillofacial Surgery, Eberhard-Karls-University of Tuebingen, Tübingen, Germany. 4. Department of Dermatology, University of Erlangen, Erlangen, Germany. 5. Institute of Clinical Epidemiology and Medical Biostatistics, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
Abstract
BACKGROUND: Sentinel lymph node biopsy (SLNB) plays an important role in the prognostic classification of melanoma and is now a standard staging procedure. However, due to the complex drainage pattern and the risk of site associated morbidity, the potential survival benefit of SLNB is controversial in head and neck (H&N) melanoma. METHODS: Patients with primary H&N melanoma with a tumor thickness ≥1.00 mm diagnosed in the Department of Dermatology, University of Tuebingen, Germany between 1991 and 2010 were included in this study. Regarding patterns of metastases, disease-free, and overall-survival, 259 patients with SLNB were compared retrospectively to 218 patients without SLNB. RESULTS: The detection of micrometastasis in SLN proved to be a significant prognostic factor in H&N patients [hazard ratio (HR) 3.69, p < 0.0001]. A significant improvement of recurrence-free survival (RFS, p = 0.011), regional lymph node metastasis-free survival (LFS, p = 0.007), and distant metastasis-free survival (DMSF, p = 0.015) was observed for patients with SLNB versus non-SLNB. Furthermore, a trend towards better overall survival (OS) was found (p = 0.053) for the SLNB group. CONCLUSIONS: SLNB improved prognostic outcome in H&N melanoma in terms of disease-free and distant metastases survival, reduced subsequent regional lymph node metastases, and showed a trend towards a better OS.
BACKGROUND: Sentinel lymph node biopsy (SLNB) plays an important role in the prognostic classification of melanoma and is now a standard staging procedure. However, due to the complex drainage pattern and the risk of site associated morbidity, the potential survival benefit of SLNB is controversial in head and neck (H&N) melanoma. METHODS:Patients with primary H&N melanoma with a tumor thickness ≥1.00 mm diagnosed in the Department of Dermatology, University of Tuebingen, Germany between 1991 and 2010 were included in this study. Regarding patterns of metastases, disease-free, and overall-survival, 259 patients with SLNB were compared retrospectively to 218 patients without SLNB. RESULTS: The detection of micrometastasis in SLN proved to be a significant prognostic factor in H&N patients [hazard ratio (HR) 3.69, p < 0.0001]. A significant improvement of recurrence-free survival (RFS, p = 0.011), regional lymph node metastasis-free survival (LFS, p = 0.007), and distant metastasis-free survival (DMSF, p = 0.015) was observed for patients with SLNB versus non-SLNB. Furthermore, a trend towards better overall survival (OS) was found (p = 0.053) for the SLNB group. CONCLUSIONS: SLNB improved prognostic outcome in H&N melanoma in terms of disease-free and distant metastases survival, reduced subsequent regional lymph node metastases, and showed a trend towards a better OS.
Authors: Kristen A Echanique; Shabnam Ghazizadeh; Andy Moon; Kera Kwan; Peter A Pellionisz; Dennis Rünger; David Elashoff; Maie St John Journal: Laryngoscope Investig Otolaryngol Date: 2021-06-21
Authors: Daniella Karassawa Zanoni; Hilda E Stambuk; Brian Madajewski; Pablo H Montero; Danielli Matsuura; Klaus J Busam; Kai Ma; Melik Z Turker; Sonia Sequeira; Mithat Gonen; Pat Zanzonico; Ulrich Wiesner; Michelle S Bradbury; Snehal G Patel Journal: JAMA Netw Open Date: 2021-03-01