BACKGROUND: Sentinel node biopsy (SNB) for melanoma patients has been questioned. We aimed to study high-risk stage II melanoma patients who underwent SNB to determine what the prognostic factors regarding recurrence and mortality were, and evaluate how relevant SNB status is in this scenario. METHODS: This was a retrospective analysis of clinical stage IIB/IIC melanoma patients who underwent SNB from 2000 to 2015 in a single institution. Prognostic factors related to distant recurrence-free survival (DRFS) and melanoma-specific survival (MSS) were assessed from multiple Cox regression. Relevant variables were used to create risk predictor nomograms for DRFS and MSS. RESULTS: From 1213 SNB, 259 were performed for clinical stage IIB/IIC melanoma patients. SNB status was the most important variable for both endpoints. Patients with positive SNB presented median DRFS of 35.73 months (95% CI 21.38-50.08, SE 7.32) and median MSS of 66.4 months (95% CI 29.76-103.03, SE 18.69), meanwhile both median DRFS and MSS were not achieved for those with negative SNB (logrank < 0.0001). Both nomograms have been internally validated and presented adequate calibration (C-index was 0.734 for DRFS and 0.718 for MSS). CONCLUSIONS: SNB status was the most important risk factor in our cohort of clinical stage IIB and IIC patients and, in conjunction with well-established primary tumor characteristics, should not be abandoned. Their use in prognosis for these patients remains extremely useful for daily practice.
BACKGROUND: Sentinel node biopsy (SNB) for melanomapatients has been questioned. We aimed to study high-risk stage II melanomapatients who underwent SNB to determine what the prognostic factors regarding recurrence and mortality were, and evaluate how relevant SNB status is in this scenario. METHODS: This was a retrospective analysis of clinical stage IIB/IIC melanomapatients who underwent SNB from 2000 to 2015 in a single institution. Prognostic factors related to distant recurrence-free survival (DRFS) and melanoma-specific survival (MSS) were assessed from multiple Cox regression. Relevant variables were used to create risk predictor nomograms for DRFS and MSS. RESULTS: From 1213 SNB, 259 were performed for clinical stage IIB/IIC melanomapatients. SNB status was the most important variable for both endpoints. Patients with positive SNB presented median DRFS of 35.73 months (95% CI 21.38-50.08, SE 7.32) and median MSS of 66.4 months (95% CI 29.76-103.03, SE 18.69), meanwhile both median DRFS and MSS were not achieved for those with negative SNB (logrank < 0.0001). Both nomograms have been internally validated and presented adequate calibration (C-index was 0.734 for DRFS and 0.718 for MSS). CONCLUSIONS: SNB status was the most important risk factor in our cohort of clinical stage IIB and IIC patients and, in conjunction with well-established primary tumor characteristics, should not be abandoned. Their use in prognosis for these patients remains extremely useful for daily practice.
Authors: Sandra L Wong; Mark B Faries; Erin B Kennedy; Sanjiv S Agarwala; Timothy J Akhurst; Charlotte Ariyan; Charles M Balch; Barry S Berman; Alistair Cochran; Keith A Delman; Mark Gorman; John M Kirkwood; Marc D Moncrieff; Jonathan S Zager; Gary H Lyman Journal: Ann Surg Oncol Date: 2017-12-13 Impact factor: 5.344
Authors: Daniëlle Verver; David van Klaveren; Alexander C J van Akkooi; Piotr Rutkowski; Barry W E M Powell; Caroline Robert; Alessandro Testori; Barbara L van Leeuwen; Astrid A M van der Veldt; Ulrich Keilholz; Alexander M M Eggermont; Cornelis Verhoef; Dirk J Grünhagen Journal: Eur J Cancer Date: 2018-04-13 Impact factor: 9.162
Authors: Donald L Morton; John F Thompson; Alistair J Cochran; Nicola Mozzillo; Omgo E Nieweg; Daniel F Roses; Harold J Hoekstra; Constantine P Karakousis; Christopher A Puleo; Brendon J Coventry; Mohammed Kashani-Sabet; B Mark Smithers; Eberhard Paul; William G Kraybill; J Gregory McKinnon; He-Jing Wang; Robert Elashoff; Mark B Faries Journal: N Engl J Med Date: 2014-02-13 Impact factor: 91.245
Authors: Eduardo Bertolli; Viola Franke; Vinicius Fernando Calsavara; Mariana Petaccia de Macedo; Clovis Antonio Lopes Pinto; Winan J van Houdt; Michel W J M Wouters; Joao Pedreira Duprat Neto; Alexander C J van Akkooi Journal: Ann Surg Oncol Date: 2018-11-19 Impact factor: 5.344
Authors: Oliver J Wisco; Justin W Marson; Graham H Litchman; Nicholas Brownstone; Kyle R Covington; Brian J Martin; Ann P Quick; Jennifer J Siegel; Hillary G Caruso; Robert W Cook; Richard R Winkelmann; Darrell S Rigel Journal: Melanoma Res Date: 2022-04-01 Impact factor: 3.199