Melanoma: predicting recurrence after negative SLN biopsy

  • Thomas DC & al.
  • Ann Surg Oncol
  • 22 avr. 2019

  • Par Brian Richardson, PhD
  • Résumés d'articles
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Takeaway

  • Age, thickness, disease site, microsatellitosis, ulceration, and lymphovascular invasion are associated with recurrence after negative sentinel lymph node biopsy (SLNB) in patients with melanoma.

Why this matters

  • Recurrence after negative SLNB has not been well studied despite affecting between 8.9% and 16.0% of patients.

Key results

  • 10.4% of patients experienced recurrence in this study.
    • First site of recurrence was local/in-transit recurrence (LITR) in 4.1% of cases, nodal recurrence (NR) in 2% of cases, distant recurrence (DR) in 4.1% of cases, and unknown site in 0.2% of cases.
  • Age ≥80 years, thickness >3 mm, head/neck or lower extremity primary, and microsatellitosis were associated with LITR as first site (P<.05 all>
  • Head/neck or lower extremity primary and thickness >2 mm were associated with NR as first site (P<.05 for all>
  • Head/neck or trunk primary, thickness >2 mm, ulceration, and lymphovascular invasion were associated with DR as first site (P<.05 for all>
  • LITR, NR, and DR were associated with reduced 5-year OS and melanoma-specific survival rates (P<.01 for all>

Study design

  • 5351 patients with melanoma with negative SLNB results from the Sentinel Lymph Node Working Group were included.
  • Funding: None.

Limitations

  • Missing data, such as histologic subtype and treatment types.
  • Relatively short median follow-up (32.1 months).