Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study

Aram Boada, 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 FerrándizIciar Pascual, José L. Manzano, Marina Sánchez-Lucas, Pol Giménez-Xavier, Lara Ferrandiz, Eduardo Nagore

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Abstract

© 2017 UICC 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.
Original languageEnglish
Pages (from-to)641-648
JournalInternational Journal of Cancer
Volume142
Issue number3
DOIs
Publication statusPublished - 1 Feb 2018

Keywords

  • melanoma
  • prognosis
  • propensity score
  • sentinel lymph node biopsy

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    Boada, A., Tejera-Vaquerizo, A., Ribero, S., Puig, S., Moreno-Ramírez, D., Descalzo-Gallego, M. A., Fierro, M. T., Quaglino, P., Carrera, C., Malvehy, J., Vidal-Sicart, S., Bennássar, A., Rull, R., Alos, L., Requena, C., Bolumar, I., Traves, V., Pla, Á., Fernández-Figueras, M. T., ... Nagore, E. (2018). Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study. International Journal of Cancer, 142(3), 641-648. https://doi.org/10.1002/ijc.31078