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Melanoma Patient-Reported Quality of Life Outcomes Following Sentinel Lymph Node Biopsy, Completion Lymphadenectomy, and Adjuvant Interferon: Results from the Sunbelt Melanoma Trial

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

Abstract

Background

Quality of life (QOL) and physical condition (PC) outcomes after sentinel lymph node biopsy (SLNB), completion lymph node dissection (CLND), and adjuvant therapy with interferon alfa-2b (IFN) were evaluated in this study.

Methods

Self-reported QOL and PC scores were evaluated in patients enrolled in a prospective, multicenter, randomized, clinical trial evaluating adjuvant IFN. After SLN biopsy, patients with a positive SLN underwent CLND then were randomized to adjuvant IFN or observation. QOL and PC scores were compared between patients who underwent SLNB alone, CLND without IFN, and CLND with IFN. Time to return to baseline QOL and PC scores reported at the time of SLNB was recorded and compared.

Results

There were statistically significant differences in time to return to baseline QOL (p = 0.0018) and PC (p = 0.0018) scores across the three treatment groups. The time to return to baseline QOL and PC scores was similar for SLND and CLND alone. Differences in time to return to baseline QOL and PC were sustained when stratified by recurrence status but did not differ significantly for different lymph node regions. There was a delay in return to baseline QOL and PC condition scores that was sustained beyond the cessation of IFN therapy.

Conclusions

CLND is well-tolerated with a similar effect on self-reported QOL outcomes in both the short- and long-term compared with SLNB alone. IFN therapy is associated with worse QOL outcomes compared with SLNB and CLND, an effect that may be sustained following cessation of adjuvant IFN.

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Disclosure

This is a study of the Sunbelt Melanoma Trial, which was sponsored by a grant from Schering Oncology Biotech. All data management and subsequent analysis has been performed independently at the University of Louisville. Schering Oncology Biotech was not involved in conduct of the trial, data analysis, or production of this manuscript.

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Authors and Affiliations

  1. The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville, Louisville, KY, USA

    Michael E. Egger MD, MPH, Charles W. Kimbrough MD, Amy R. Quillo MD, Robert C. G. Martin II MD, PhD, Charles R. Scoggins MD, MBA & Kelly M. McMasters MD, PhD

  2. Department of Statistics, University of Kentucky, Lexington, KY, USA

    Arnold J. Stromberg PhD

Authors
  1. Michael E. Egger MD, MPH
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  2. Charles W. Kimbrough MD
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  3. Arnold J. Stromberg PhD
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  4. Amy R. Quillo MD
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  5. Robert C. G. Martin II MD, PhD
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  6. Charles R. Scoggins MD, MBA
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  7. Kelly M. McMasters MD, PhD
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Corresponding author

Correspondence to Kelly M. McMasters MD, PhD.

Electronic supplementary material

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Supplementary Figure 1

Comparison of self-reported Physical Condition and Quality of Life Scores associated with the presence or absence of specific complaints (all p values for test of differences < 0.0001, error bars represent 95% confidence intervals). Supplementary material 1 (TIFF 68 kb)

Supplementary Figure 2

Time to return to baseline quality of life (A) and physical condition (B) scores in patients undergoing completion lymph node dissection. Supplementary material 2 (TIFF 64 kb)

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Egger, M.E., Kimbrough, C.W., Stromberg, A.J. et al. Melanoma Patient-Reported Quality of Life Outcomes Following Sentinel Lymph Node Biopsy, Completion Lymphadenectomy, and Adjuvant Interferon: Results from the Sunbelt Melanoma Trial. Ann Surg Oncol 23, 1019–1025 (2016). https://doi.org/10.1245/s10434-015-5074-2

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  • DOI: https://doi.org/10.1245/s10434-015-5074-2

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