Antonio Tejera-Vaquerizo1, Miguel Angel Descalzo-Gallego2, Victor Traves3, Celia Requena4, Isidro Bolumar5, Angel Pla6, Eduardo Nagore4. 1. Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), Spain. 2. Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, Spain. 3. Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, Spain. 4. Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain. 5. Servicio de Cirugía, Instituto Valencia de Oncología, Valencia, Spain. 6. Servicio de Otorrinolaringología, Instituto Valenciano de Oncología, Valenciano, Spain.
Abstract
BACKGROUND: Time between primary melanoma excision and sentinel lymph node biopsy (SLNB) has not been sufficiently studied as an independent predictor of survival in cutaneous melanoma. OBJECTIVES: We used propensity score matching to evaluate whether early SLNB (performed ≤40 days from excisional biopsy) is associated with higher mortality in patients with cutaneous melanoma. MATERIALS & METHODS: A retrospective cohort study at a tertiary melanoma referral centre. We included 787 consecutive patients from the melanoma database of the Instituto Valenciano de Oncología who underwent a SLNB between 1st January 2000 and 31st December 2015, of whom 350 were matched into pairs using propensity score matching. The variable of interest was the time between primary melanoma excision and SLNB (≤40 days vs >40 days). The study outcomes were disease-free survival (DFS), melanoma-specific survival (MSS), and overall survival (OS). RESULTS: A delay time of 40 days or less was associated with worse DSF (adjusted hazard ratio [AHR]: 1.68; 95% confidence interval [CI]: 1.07-2.65; p = 0.024), MSS (AHR: 2.06; 95% CI: 1.1-3.53; p = 0.08), and OS (AHR: 1.77; 95% CI: 1.11-2.83; p = 0.017). Other variables associated with shorter MSS were age, tumour location and thickness, mitotic rate, and SLN status. CONCLUSION: Early SLNB was associated with worse survival in patients with cutaneous melanoma after adjusting for classic prognostic factors. A delay time of over 40 days was not associated with higher mortality.
BACKGROUND: Time between primary melanoma excision and sentinel lymph node biopsy (SLNB) has not been sufficiently studied as an independent predictor of survival in cutaneous melanoma. OBJECTIVES: We used propensity score matching to evaluate whether early SLNB (performed ≤40 days from excisional biopsy) is associated with higher mortality in patients with cutaneous melanoma. MATERIALS & METHODS: A retrospective cohort study at a tertiary melanoma referral centre. We included 787 consecutive patients from the melanoma database of the Instituto Valenciano de Oncología who underwent a SLNB between 1st January 2000 and 31st December 2015, of whom 350 were matched into pairs using propensity score matching. The variable of interest was the time between primary melanoma excision and SLNB (≤40 days vs >40 days). The study outcomes were disease-free survival (DFS), melanoma-specific survival (MSS), and overall survival (OS). RESULTS: A delay time of 40 days or less was associated with worse DSF (adjusted hazard ratio [AHR]: 1.68; 95% confidence interval [CI]: 1.07-2.65; p = 0.024), MSS (AHR: 2.06; 95% CI: 1.1-3.53; p = 0.08), and OS (AHR: 1.77; 95% CI: 1.11-2.83; p = 0.017). Other variables associated with shorter MSS were age, tumour location and thickness, mitotic rate, and SLN status. CONCLUSION: Early SLNB was associated with worse survival in patients with cutaneous melanoma after adjusting for classic prognostic factors. A delay time of over 40 days was not associated with higher mortality.
Authors: M Arenbergerova; A Lallas; E Nagore; L Rudnicka; A M Forsea; M Pasek; F Meier; K Peris; J Olah; C Posch Journal: J Eur Acad Dermatol Venereol Date: 2021-04-13 Impact factor: 6.166