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

• J. A. Avilés Izquierdo ^[1] ; L. M. Nieto Benito ^[1] ; P. Lázaro Ochaita ^[1] ; J. L. Escat Cortés ^[2] ; I. Marquez Rodas ^[3] ; E. Mercader Cidoncha ^[2]
  1. [1] Dermatology Department, Hospital Universitario Gregorio Marañón, C/Dr Esquerdo No. 46, 28007 Madrid, Spain
  2. [2] General and Digestive Surgery Department, Hospital Universitario Gregorio Marañón, C/Dr Esquerdo No. 46, 28007 Madrid, Spain
  3. [3] Medical Oncology Department, Hospital Universitario Gregorio Marañón, C/Dr Esquerdo No. 46, 28007 Madrid, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 9, 2020, págs. 1611-1618
• Idioma: inglés
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• Resumen

  • 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.