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The Impact of Smoking on Sentinel Node Metastasis of Primary Cutaneous Melanoma

  • Melanomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although a well-established causative relationship exists between smoking and several epithelial cancers, the association of smoking with metastatic progression in melanoma is not well studied. We hypothesized that smokers would be at increased risk for melanoma metastasis as assessed by sentinel lymph node (SLN) biopsy.

Methods

Data from the first international Multicenter Selective Lymphadenectomy Trial (MSLT-I) and the screening-phase of the second trial (MSLT-II) were analyzed to determine the association of smoking with clinicopathologic variables and SLN metastasis.

Results

Current smoking was strongly associated with SLN metastasis (p = 0.004), even after adjusting for other predictors of metastasis. Among 4231 patients (1025 in MSLT-I and 3206 in MSLT-II), current or former smoking was also independently associated with ulceration (p < 0.001 and p < 0.001, respectively). Compared with current smoking, never smoking was independently associated with decreased Breslow thickness in multivariate analysis (p = 0.002) and with a 0.25 mm predicted decrease in thickness.

Conclusion

The direct correlation between current smoking and SLN metastasis of primary cutaneous melanoma was independent of its correlation with tumor thickness and ulceration. Smoking cessation should be strongly encouraged among patients with or at risk for melanoma.

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Acknowledgments

This study was supported by Grants CA189163 and CA29605 from the National Cancer Institute, and by funding from the Amyx Foundation, Inc. Boise, ID, USA; the Borstein Family Foundation, Los Angeles, CA, USA; Dr Miriam and Sheldon G. Adelson Medical Research Foundation, Boston, MA, USA; and the John Wayne Cancer Institute Auxiliary, Santa Monica, CA, USA. Dr Maris S. Jones is the Harold McAlister Charitable Foundation Fellow. The content of this report is solely the responsibility of the authors and does not necessarily represent the official view of the National Cancer Institute or the National Institutes of Health.

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Authors and Affiliations

  1. Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA

    Maris S. Jones MD & Peter C. Jones MD

  2. Department of Molecular Oncology, John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA

    Peter C. Jones MD & Dave S. B. Hoon PhD

  3. Department of Biostatistics, John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA

    Stacey L. Stern MS

  4. UCLA Department of Biostatistics, Los Angeles, CA, USA

    David Elashoff PhD

  5. Melanoma Institute Australia, Sydney, NSW, Australia

    John Thompson MBBS, FRACS, FACS & Omgo E. Nieweg MD, PhD, FRACS

  6. Istituto Nazionale dei Tumori Napoli, Napoli, Italy

    Nicola Mozzillo MD

  7. IHC Cancer Services, Intermountain Medical Center, Salt Lake City, UT, USA

    Dirk Noyes MD & Tawnya Bowles MD

  8. Universitair Medisch Centrum Groningen, Groningen, The Netherlands

    Harald J. Hoekstra MD, PhD

  9. H. Lee Moffitt Cancer Center, Tampa, USA

    Jonathan S. Zager MD

  10. NYU Langone Medical Center, New York, USA

    Daniel F. Roses MD

  11. Istituto Europeo di Oncologia, Milano, Italy

    Alessandro Testori MD

  12. Royal Adelaide Hospital Discipline of Surgery, Royal Adelaide HospitalUniversity of Adelaide, Adelaide, SA, Australia

    Brendon J. Coventry MBBS, PhD

  13. Princess Alexandra Hospital, Woolloongabba, Queensland, Australia

    Mark B. Smithers MBBS, FRACS, FRCSEng, FRCSEd

  14. Huntsman Cancer Institute, Salt Lake City, USA

    Robert Andtbacka MD

  15. Ohio State University, Columbus, USA

    Doreen Agnese MD

  16. Nuremberg General Hospital - Paracelsus Medical University, Nuremberg, Germany

    Erwin Schultz MD

  17. Saint Louis University, St. Louis, USA

    Eddy C. Hsueh MD

  18. Vanderbilt University, Nashville, USA

    Mark Kelley MD, MMHC, FACS & Douglas Johnson MD, MSCI

  19. Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

    Schlomo Schneebaum MD

  20. Johns Hopkins Medical Institute, Baltimore, USA

    Lisa Jacobs MD

  21. California Pacific Medical Center, San Francisco, USA

    Mohammed Kashani-Sabet MD

  22. Department of Melanoma Research, John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA, USA

    Mark B. Faries MD

Authors
  1. Maris S. Jones MD
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  2. Peter C. Jones MD
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  3. Stacey L. Stern MS
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  6. John Thompson MBBS, FRACS, FACS
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  7. Nicola Mozzillo MD
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  8. Omgo E. Nieweg MD, PhD, FRACS
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  9. Dirk Noyes MD
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  10. Harald J. Hoekstra MD, PhD
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  11. Jonathan S. Zager MD
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  12. Daniel F. Roses MD
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  13. Alessandro Testori MD
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  14. Brendon J. Coventry MBBS, PhD
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  15. Mark B. Smithers MBBS, FRACS, FRCSEng, FRCSEd
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  16. Robert Andtbacka MD
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  17. Doreen Agnese MD
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  18. Erwin Schultz MD
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  19. Eddy C. Hsueh MD
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  20. Mark Kelley MD, MMHC, FACS
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  21. Schlomo Schneebaum MD
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  22. Lisa Jacobs MD
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  23. Tawnya Bowles MD
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  24. Mohammed Kashani-Sabet MD
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  25. Douglas Johnson MD, MSCI
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  26. Mark B. Faries MD
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Corresponding author

Correspondence to Mark B. Faries MD.

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Jones, M.S., Jones, P.C., Stern, S.L. et al. The Impact of Smoking on Sentinel Node Metastasis of Primary Cutaneous Melanoma. Ann Surg Oncol 24, 2089–2094 (2017). https://doi.org/10.1245/s10434-017-5775-9

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  • DOI: https://doi.org/10.1245/s10434-017-5775-9

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