학술논문
The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086).
Document Type
Academic Journal
Author
Tropea S; Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV- IRCCS, 35128, Padua, Italy.; Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padua, Italy.; Del Fiore P; Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV- IRCCS, 35128, Padua, Italy. paolo.delfiore@iov.veneto.it.; Maurichi A; Fondazione IRCCS Istituto Nazionale Dei Tumori, Melanoma and Sarcoma Unit, Milan, Italy.; Patuzzo R; Fondazione IRCCS Istituto Nazionale Dei Tumori, Melanoma and Sarcoma Unit, Milan, Italy.; Santinami M; Fondazione IRCCS Istituto Nazionale Dei Tumori, Melanoma and Sarcoma Unit, Milan, Italy.; Ribero S; Department of Dermatologic Surgery, Città della Salute e della Scienza, Turin, Italy.; Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy.; Quaglino P; Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy.; Caliendo V; Dermatologic Surgery Section, Oncologic Department, 'Città Della Salute E Della Scienza Di Torino' University Hospital, Turin, Italy.; Borgognoni L; SOC Chirurgia Plastica Ricostruttiva E Melanoma & Skin Cancer Unit, Osp. SM Annunziata, AUSL Toscana Centro, Florence, Italy.; Sestini S; SOC Chirurgia Plastica Ricostruttiva E Melanoma & Skin Cancer Unit, Osp. SM Annunziata, AUSL Toscana Centro, Florence, Italy.; Giudice G; U.O.C. Di Chirurgia Plastica Ricostruttiva E Centro Ustioni Policlinico, University of Bari, Bari, Italy.; Nacchiero E; U.O.C. Di Chirurgia Plastica Ricostruttiva E Centro Ustioni Policlinico, University of Bari, Bari, Italy.; Caracò C; Corrado Caracò M.D., Struttura Complessa Chirurgia Oncologica Melanoma - Istituto Nazionale Tumori-Fondazione 'G. Pascale', Naples, Italy.; Cordova A; Department- of Surgical Oncologic and Stomatologic Sciences, University of Palermo, Palermo, Italy.; Solari N; Chirurgia Ospedaliera 1 Ospedale Policlinico San Martino, Genoa, Italy.; Piazzalunga D; Chirurgia Generale 1, Ospedale Papa Giovanni XXIII, Bergamo, Italy.; Tauceri F; Chirurgia E Terapie Oncologiche Avanzate Ospedale 'GB.Morgagni-L.Pierantoni' - AUSL Forlì, Forlì, Italy.; Carcoforo P; UOC Chirurgia II Azienda Ospedaliera Universitaria Di Ferrara, Ferrara, Italy.; Lombardo M; Dermatology Unit, Department of Specialistic Medicine, ASST Dei Sette Laghi, Varese, Italy.; Cavallari S; M.D. S. C. Chirurgia Generale ASST Carlo Poma, Mantua, Italy.; Mocellin S; Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV- IRCCS, 35128, Padua, Italy.; Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padua, Italy.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The management of melanoma patients with metastatic melanoma in the sentinel nodes (SN) is evolving based on the results of trials questioning the impact of completion lymph node dissection (CLND) and demonstrating the efficacy of new adjuvant treatments. In this landscape, new prognostic tools for fine risk stratification are eagerly sought to optimize the therapeutic path of these patients.
Methods: A retrospective cohort of 2,086 patients treated with CLND after a positive SN biopsy in thirteen Italian Melanoma Centers was reviewed. Overall survival (OS) was the outcome of interest; included independent variables were the following: age, gender, primary melanoma site, Breslow thickness, ulceration, sentinel node tumor burden (SNTB), number of positive SN, non-sentinel lymph nodes (NSN) status. Univariate and multivariate survival analyses were performed using the Cox proportional hazard regression model.
Results: The 3-year, 5-year and 10-year OS rates were 79%, 70% and 54%, respectively. At univariate analysis, all variables, except for primary melanoma body site, were found to be statistically significant prognostic factors. Multivariate Cox regression analysis indicated that older age (P < 0.0001), male gender (P = 0.04), increasing Breslow thickness (P < 0.0001), presence of ulceration (P = 0.004), SNTB size (P < 0.0001) and metastatic NSN (P < 0.0001) were independent negative predictors of OS.
Conclusion: The above results were utilized to build a nomogram in order to ease the practical implementation of our prognostic model, which might improve treatment personalization.
(© 2022. The Author(s).)
Methods: A retrospective cohort of 2,086 patients treated with CLND after a positive SN biopsy in thirteen Italian Melanoma Centers was reviewed. Overall survival (OS) was the outcome of interest; included independent variables were the following: age, gender, primary melanoma site, Breslow thickness, ulceration, sentinel node tumor burden (SNTB), number of positive SN, non-sentinel lymph nodes (NSN) status. Univariate and multivariate survival analyses were performed using the Cox proportional hazard regression model.
Results: The 3-year, 5-year and 10-year OS rates were 79%, 70% and 54%, respectively. At univariate analysis, all variables, except for primary melanoma body site, were found to be statistically significant prognostic factors. Multivariate Cox regression analysis indicated that older age (P < 0.0001), male gender (P = 0.04), increasing Breslow thickness (P < 0.0001), presence of ulceration (P = 0.004), SNTB size (P < 0.0001) and metastatic NSN (P < 0.0001) were independent negative predictors of OS.
Conclusion: The above results were utilized to build a nomogram in order to ease the practical implementation of our prognostic model, which might improve treatment personalization.
(© 2022. The Author(s).)