Multicenter analysis of the surgical management and adjuvant therapy of patients with melanoma and a positive sentinel lymph node biopsy

被引：0

作者：

Samaniego-Gonzalez, E. ^{[1
]}

Podlipnik, S. ^{[2
]}

Ribero, S. ^{[3
]}

Nagore, E. ^{[4
]}

Boada, A. ^{[5
]}

Canueto, J. ^{[6
]}

Paradela, S. ^{[7
]}

de Unamuno, B. ^{[8
]}

Rodriguez-Jimenez, P. ^{[9
]}

Puig, S. ^{[2
]}

Malvehy, J. ^{[2
]}

Carrera, C. ^{[2
]}

Roccuzzo, G. ^{[2
]}

Requena, C. ^{[4
]}

Manrique-Silva, E. ^{[4
]}

Richarz, N. ^{[5
]}

Ruiz-Villanueva, A. ^{[10
]}

Traves, V. ^{[11
]}

Espana-Fernandez, S. ^{[12
]}

Botella-Estrada, R. ^{[8
]}

Gonzalez-Moran, M. A. ^{[13
]}

Tejera-Vaquerizo, A. ^{[14
,15
]}

机构：

[1] Univ Leon, Complejo Asistencial Univ Leon, Serv Dermatol, Inst Biomed IBIOMED, Leon, Spain

[2] Univ Barcelona, Hosp Clin Barcelona, Ctr Invest Biomed Red Enfermedades Raras, Serv Dermatol,IDIBAPS, Barcelona, Spain

[3] Univ Turin, Dept Ciencias Med, Clin Dermatolog, Turin, Italy

[4] Inst Valenciano Oncol, Serv Dermatol, Valencia, Spain

[5] Hosp Germans Trias iPujol Badalona, Serv Dermatol, Badalona, Spain

[6] Complejo Asistencial Univ Salamanca, Serv Dermatol, Inst Invest Biomed IBSAL CANC 30, Salamanca, Spain

[7] Complejo Hospitalario A Corun, Serv Dermatol, La Coruna, Spain

[8] Hosp La Fe Valencia, Serv Dermatol, Valencia, Spain

[9] Hosp La Princesa Madrid, Serv Dermatol, Madrid, Spain

[10] Complejo Asistencial Univ Salamanca, Serv Dermatol, Salamanca, Spain

[11] Serv Anat Patol, Inst Valenciano Oncol, Valencia, Spain

[12] Hosp Germans Trias i Pujol Badalona, Serv Oncol Med, Inst Catalan Oncol, Badalona, Spain

[13] Complejo Asistencial Univ Leon, Serv Anat Patol, Leon, Spain

[14] Hosp San Juan Dios, Unidad Oncol Cutanea, Cordoba, Spain

[15] Serv Dermatol, Inst Dermatol GlobalDerm, Palma Del Rio, Cordoba, Spain

来源：

ACTAS DERMO-SIFILIOGRAFICAS | 2025年 / 116卷 / 03期

关键词：

Melanoma; Surveillance; Lymph node dissection; Sentinel lymph node biopsy; Adjuvant therapy; Pathology; CLINICAL-PRACTICE GUIDELINE; STAGE-III; DISSECTION; HEAD; PROGRESSION; IPILIMUMAB; RISK;

D O I：

10.1016/j.ad.2024.07.017

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Introduction: Complete lymph node dissection (CLND) was the standard practice for patients with melanoma and a positive sentinel lymph node biopsy (SLNB) until the results of 2 clinical trials published in 2016 and 2017 demonstrated that it did not improve melanoma-specific survival (MSS). However, it continues to be performed in some scenarios. No studies have ever been published on lymph node management after a positive SLNB in the routine clinical practice in our setting. Objectives: To determine the evolution of the indication for CLND in patients with a positive SLNB, as well as the characteristics associated with its performance. Material and methods: We conducted a multicenter retrospective observational study with patients with skin melanoma and positive sentinel lymph nodes diagnosed from 2017 through 2022 at 8 Spanish centers and 1 Italian center. Results: A total of 430 patients were included, 54% men, with 358 (75.1%) aged between 45 and 80 years. A total of 133 cases (31%) exhibited Breslow thickness > 4mm, 206 cases (49.1%) were ulcerated, and in 213 cases (55.7%), lymph node metastasis was > 1 mm. Isolated lymphadenectomy or followed by adjuvant therapy was performed in 146 patients (34.1%). After multivariate logistic regression, the factors associated with the performance of CLND were the acral lentiginous melanoma histological subtype, lymph node metastasis size > 1 mm, extracapsular spread, and the participant hospital. Age > 80 years was inversely associated. Conclusion: While the frequency of CLND in patients with melanoma and positive SLNB has decreased, the indication for systemic adjuvant therapy in these patients has increased. However, CLND is still indicated in patients with high-risk characteristics. (c) 2024 AEDV. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：233 / 244

页数：12

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