David R Thomson1, Milap G Rughani2, Rachel Kuo2, Oliver C S Cassell2. 1. Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals, Oxford OX3 9DU, United Kingdom. Electronic address: davidthomson134@gmail.com. 2. Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals, Oxford OX3 9DU, United Kingdom.
Abstract
INTRODUCTION: Sentinel lymph node biopsy (SLNB) is widely used as a key investigatory tool for cutaneous melanoma, with results incorporated into the latest AJCC staging guidelines. We present the results of our extended follow-up of sentinel lymph node biopsy for melanoma over a sixteen-year period. METHODS: Data were collected prospectively from June 1998 to December 2014 from a single tertiary skin cancer referral centre. Chi-squared analysis was used to analyse patient demographics and primary tumour pathology. Survival analysis was conducted using Cox regression models and Kaplan-Meier survival curves. RESULTS: Over a sixteen-year period 1527 patients underwent SLNB in 1609 basins, with 2876 nodes harvested. 347 patients (23%) had a positive biopsy. The most common primary tumour sites for males was the back (32%); women had a significantly higher number of melanomas occurring on the lower and upper limbs (45% and 26% respectively) [all p < 0.0001, Chi-squared]. Mean follow-up time was 4.9 years. Patients with a positive SLNB at diagnosis were significantly more likely to die from melanoma (subhazard ratio 5.59, p = 0.000, 95% CI 3.59-8.69). Breslow thickness and ulceration were also significant predictors of melanoma-specific mortality. For patients with a primary Breslow >4.0 mm ten-year disease free survival was 52% for SLNB negative and 26% for SLNB positive patients. For Breslow thicknesses of 2.01-4 mm these values were 66% and 32% respectively. CONCLUSIONS: Sentinel lymph node biopsy status is strongly predictive of survival across all thicknesses of primary cutaneous melanoma.
INTRODUCTION: Sentinel lymph node biopsy (SLNB) is widely used as a key investigatory tool for cutaneous melanoma, with results incorporated into the latest AJCC staging guidelines. We present the results of our extended follow-up of sentinel lymph node biopsy for melanoma over a sixteen-year period. METHODS: Data were collected prospectively from June 1998 to December 2014 from a single tertiary skin cancer referral centre. Chi-squared analysis was used to analyse patient demographics and primary tumour pathology. Survival analysis was conducted using Cox regression models and Kaplan-Meier survival curves. RESULTS: Over a sixteen-year period 1527 patients underwent SLNB in 1609 basins, with 2876 nodes harvested. 347 patients (23%) had a positive biopsy. The most common primary tumour sites for males was the back (32%); women had a significantly higher number of melanomas occurring on the lower and upper limbs (45% and 26% respectively) [all p < 0.0001, Chi-squared]. Mean follow-up time was 4.9 years. Patients with a positive SLNB at diagnosis were significantly more likely to die from melanoma (subhazard ratio 5.59, p = 0.000, 95% CI 3.59-8.69). Breslow thickness and ulceration were also significant predictors of melanoma-specific mortality. For patients with a primary Breslow >4.0 mm ten-year disease free survival was 52% for SLNB negative and 26% for SLNB positive patients. For Breslow thicknesses of 2.01-4 mm these values were 66% and 32% respectively. CONCLUSIONS: Sentinel lymph node biopsy status is strongly predictive of survival across all thicknesses of primary cutaneous melanoma.
Authors: Xiaoting Wei; Di Wu; Hang Li; Rui Zhang; Yu Chen; Hong Yao; Zhihong Chi; Xinan Sheng; Chuanliang Cui; Xue Bai; Zhonghui Qi; Ke Li; Shijie Lan; Lizhu Chen; Rui Guo; Xinyu Yao; Lili Mao; Bin Lian; Yan Kong; Jie Dai; Bixia Tang; Xieqiao Yan; Xuan Wang; Siming Li; Li Zhou; Charles M Balch; Lu Si; Jun Guo Journal: Ann Surg Oncol Date: 2020-04-06 Impact factor: 5.344