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Prognostic significance of sentinel node biopsy status in cutaneous melanoma: a 21-years prospective study from a single institution

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Abstract

Aim

To analyze the accuracy of the sentinel lymphatic node biopsy (SLNB) and to investigate predictive factors for sentinel node (SN) status and prognostic factors for recurrence-free survival (RFS) and disease-specific survival (DSS) in patients with melanoma.

Material and methods

Between June 1997 and June 2017, 440 consecutive patients, who underwent SLNB by a single surgical team, were prospectively included. Descriptive and survival analysis were performed.

Results

119 of 440 patients (26%) had positive SN. SLNB's false-negative rate was 6.3%. Breslow thickness, Clark´s level, ulceration and histological subtype were statistically significant predictive factors of SN metastases. In a multivariate analysis, positive SN (HR = 2.21, p = 0.01), deeper Breslow thickness (HR = 2.05, p = 0.013), male gender (RR = 2.05, p = 0.02), and higher Clark’s level (HR = 2.30, p = 0.043) were significantly associated with decreased RFS; and positive SN (HR = 2.58, p < 0.001), deeper Breslow thickness (HR = 2.57, p = 0.006) and male gender (HR = 1.93, p = 0.006) were associated with lower DSS.

Conclusion

SLNB is a reliable and reproducible procedure with high sensitivity (93.7%). Positive SN metastases, Breslow thickness and male gender were statistically associated with poorer outcomes. Male gender was an independent prognostic factor of tumor thickness or SN status.

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Authors and Affiliations

  1. Dermatology Department, Hospital Universitario Gregorio Marañón, C/Dr Esquerdo No. 46, 28007, Madrid, Spain

    J. A. Avilés-Izquierdo, L. M. Nieto-Benito & P. Lázaro-Ochaita

  2. General and Digestive Surgery Department, Hospital Universitario Gregorio Marañón, C/Dr Esquerdo No. 46, 28007, Madrid, Spain

    J. L. Escat-Cortés & E. Mercader-Cidoncha

  3. Medical Oncology Department, Hospital Universitario Gregorio Marañón, C/Dr Esquerdo No. 46, 28007, Madrid, Spain

    I. Marquez-Rodas

  4. Instituto Investigación Sanitaria Gregorio Marañón, Hospital Universitario Gregorio Marañón, C/Dr Esquerdo No. 46, 28007, Madrid, Spain

    E. Mercader-Cidoncha

Authors
  1. J. A. Avilés-Izquierdo
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  2. L. M. Nieto-Benito
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  3. P. Lázaro-Ochaita
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Correspondence to E. Mercader-Cidoncha.

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Conflict of interest

The authors declare no potential conflicts of interest (financial or non-financial). Iván Márquez-Rodas declares the following COIs: received grants as advisory board, travel and congress accommodation from: BMS, MSD, Roche, Novartis, Amgen, Pierre-Fabre, Merck Serono, Sanofi, Regeneron, Incyte, Astra Zeneca, Bioncotech.

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Data were collected according following ethical principles and ethical professional conduct.

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Our research involved human participants who had obtained informed consents. The study fulfills the declaration of Helsinki ethical standards for research.

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Avilés-Izquierdo, J.A., Nieto-Benito, L.M., Lázaro-Ochaita, P. et al. Prognostic significance of sentinel node biopsy status in cutaneous melanoma: a 21-years prospective study from a single institution. Clin Transl Oncol 22, 1611–1618 (2020). https://doi.org/10.1007/s12094-020-02306-w

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  • DOI: https://doi.org/10.1007/s12094-020-02306-w

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