Effects of time interval between primary melanoma excision and sentinel node biopsy on positivity rate and survival

被引：29

作者：

Ophuis, Charlotte M. C. Oude ^{[1
]}

van Akkooi, Alexander C. J. ^{[2
]}

Rutkowski, Piotr ^{[3
,4
]}

Voit, Christiane A. ^{[5
]}

Stepniak, Joanna ^{[3
,4
]}

Erler, Nicole S. ^{[6
,7
]}

Eggermont, Alexander M. M. ^{[1
,8
]}

Wouters, Michel W. J. M.

Grunhagen, Dirk J. ^{[1
]}

Verhoef, Cornelis ^{[1
]}

机构：

[1] Erasmus MC Canc Inst, Dept Surg Oncol, Groene Hilledijk 301, NL-3075 EA Rotterdam, Netherlands

[2] Netherlands Canc Inst, Dept Surg Oncol, Amsterdam, Netherlands

[3] Maria Sklodowska Curie Mem Canc Ctr, Dept Soft Tissue Bone Sarcoma & Melanoma, Warsaw, Poland

[4] Maria Sklodowska Curie Mem Canc Ctr, Inst Oncol, Warsaw, Poland

[5] Charite, Med Berlin, Dept Dermatol Venerol & Allergol, Berlin, Germany

[6] Erasnius Med Ctr, Dept Biostat, Rotterdam, Netherlands

[7] Erasmus MC, Dept Epidemiol, Rotterdam, Netherlands

[8] Gustave Roussy Canc Campus Grand Paris, Dept Surg Oncol, Villejuif, France

来源：

EUROPEAN JOURNAL OF CANCER | 2016年 / 67卷

关键词：

Melanoma; Sentinel lymph node biopsy; Sentinel node; Prognosis; Survival; Timing of surgery; Wait list; LYMPH-NODES; IDENTIFICATION; GUIDELINES; MARGINS; RISK; MM;

D O I：

10.1016/j.ejca.2016.08.014

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Sentinel node biopsy (SNB) is essential for adequate melanoma staging. Most melanoma guidelines advocate to perform wide local excision and SNB as soon as possible, causing time pressure. Objective: To investigate the role of time interval between melanoma diagnosis and SNB on sentinel node (SN) positivity and survival. Methods: This is a retrospective observational study concerning a cohort of melanoma patients from four European Organization for Research and Treatment of Cancer Melanoma Group tertiary referral centres from 1997 to 2013. A total of 4124 melanoma patients underwent SNB. Patients were selected if date of diagnosis and follow-up (FU) information were available, and SNB was performed in <180 d. A total of 3546 patients were included. Multi variable logistic regression and Cox regression analyses were performed to investigate how baseline characteristics and time interval until SNB are related to positivity rate, disease-free survival (DFS) and melanoma-specific survival (MSS). Findings: Median time interval was 43 d (interquartile range [IQR] 29-60 d), and 705 (19.9%) of 3546 patients had a positive SN. Sentinel node positivity was equal for early surgery (<= 43 d) versus late surgery (>43 d): 19.7% versus 20.1% (p = 0.771). Median FU was 50 months (IQR 24-84 months). Sentinel node metastasis (hazard ratio [HR] 3.17, 95% confidence interval [95% CI] 2.53-3.97), ulceration (HR 1.99, 95% CI 1.58-2.51), Breslow thickness (HR 1.06, 95% CI 1.04-1.08), and male gender (HR 1.58, 95% CI 1.26-1.98) (all p < 0.00001) were independently associated with worse MSS and DFS; time interval was not. Interpretation: No effect of time interval between melanoma diagnosis and SNB on 5-year survival or SN positivity rate was found for a time interval of up to 3 months. This information can be used to counsel patients and remove strict time limits from melanoma guidelines. (C) 2016 Elsevier Ltd. All rights reserved.

引用

页码：164 / 173

页数：10

共 29 条

[11] The development of optimal pathological assessment of sentinel lymph nodes for melanoma [J].

Cook, MG ;

Green, MA ;

Anderson, B ;

Eggermont, AMM ;

Ruiter, DJ ;

Spatz, A ;

Kissin, MW ;

Powell, BWEM .

JOURNAL OF PATHOLOGY, 2003, 200 (03) :314-319

[12] Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upaEuro [J].

Dummer, R. ;

Hauschild, A. ;

Lindenblatt, N. ;

Pentheroudakis, G. ;

Keilholz, U. .

ANNALS OF ONCOLOGY, 2015, 26 :V126-V132

[13] Diagnosis and treatment of melanoma: European consensus-based interdisciplinary guideline [J].

Garbe, Claus ;

Peris, Ketty ;

Hauschild, Axel ;

Saiag, Philippe ;

Middleton, Mark ;

Spatz, Alain ;

Grob, Jean-Jacques ;

Malvehy, Josep ;

Newton-Bishop, Julia ;

Stratigos, Alexander ;

Pehamberger, Hubert ;

Eggermont, Alexander .

EUROPEAN JOURNAL OF CANCER, 2010, 46 (02) :270-283

[14] Minimum Safe Pathologic Excision Margins for Primary Cutaneous Melanomas (1-2 mm in Thickness): Analysis of 2131 Patients Treated at a Single Center [J].

Haydu, Lauren E. ;

Stollman, Joram T. ;

Scolyer, Richard A. ;

Spillane, Andrew J. ;

Quinn, Michael J. ;

Saw, Robyn P. M. ;

Shannon, Kerwin F. ;

Stretch, Jonathan R. ;

Bonenkamp, Johannes J. ;

Thompson, John F. .

ANNALS OF SURGICAL ONCOLOGY, 2016, 23 (04) :1071-1081

[15] Wide versus narrow excision margins for high-risk, primary cutaneous melanomas: long-term follow-up of survival in a randomised trial [J].

Hayes, Andrew J. ;

Maynard, Lauren ;

Coombes, Gillian ;

Newton-Bishop, Julia ;

Timmons, Michael ;

Cook, Martin ;

Theaker, Jeff Rey ;

Bliss, Judith M. ;

Thomas, J. Meirion .

LANCET ONCOLOGY, 2016, 17 (02) :184-192

[16] Predictive factors for sentinel lymph nodes and non-sentinel lymph nodes metastatic involvement: a database study of 1,041 melanoma patients [J].

Kibrite, Antoine ;

Milot, Helene ;

Douville, Pierre ;

Gagne, Eric J. ;

Labonte, Sebastien ;

Friede, Juan ;

Morin, Francis ;

Ouellet, Jean-Francois ;

Claveau, Joel .

AMERICAN JOURNAL OF SURGERY, 2016, 211 (01) :89-94

[17] The time from diagnostic excision biopsy to wide local excision for primary cutaneous malignant melanoma may not affect patient survival [J].

McKenna, DB ;

Lee, RJ ;

Prescott, RJ ;

Doherty, VR .

BRITISH JOURNAL OF DERMATOLOGY, 2002, 147 (01) :48-54

[18] Final Trial Report of Sentinel-Node Biopsy versus Nodal Observation in Melanoma [J].

Morton, D. L. ;

Thompson, J. F. ;

Cochran, A. J. ;

Mozzillo, N. ;

Nieweg, O. E. ;

Roses, D. F. ;

Hoekstra, H. J. ;

Karakousis, C. P. ;

Puleo, C. A. ;

Coventry, B. J. ;

Kashani-Sabet, M. ;

Smithers, B. M. ;

Paul, E. ;

Kraybill, W. G. ;

McKinnon, J. G. ;

Wang, H. -J. ;

Elashoff, R. ;

Faries, M. B. .

NEW ENGLAND JOURNAL OF MEDICINE, 2014, 370 (07) :599-609

[19] The effect of delay time between primary melanoma biopsy and sentinel lymph node dissection on sentinel node status, recurrence, and survival [J].

Parrett, Brian M. ;

Accortt, Neil A. ;

Li, Rui ;

Dosanjh, Amarjit S. ;

Thummala, Suresh ;

Kullar, Raj ;

Cleaver, James E. ;

Kashani-Sabet, Mohammed ;

Leong, Stanley P. L. .

MELANOMA RESEARCH, 2012, 22 (05) :386-391

[20] Contemporary controversies and perspectives in the staging and treatment of patients with lymph node metastasis from melanoma, especially with regards positive sentinel lymph node biopsy [J].

Pasquali, Sandro ;

Spillane, Andrew .

CANCER TREATMENT REVIEWS, 2014, 40 (08) :893-899

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