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Sentinel node status in melanoma patients is not predictive for overall survival upon multivariate analysis.
- Source :
-
British journal of cancer [Br J Cancer] 2005 Feb 28; Vol. 92 (4), pp. 662-7. - Publication Year :
- 2005
-
Abstract
- Sentinel lymph node biopsy (SLNB) has become a widely accepted standard procedure in the staging of patients with cutaneous melanoma and absence of clinical lymph node metastases, although there is no final proof that SLNB influences overall survival in these patients. This study investigated the accuracy of SLNB and the clinical outcome of patients after a mean follow-up of 22 months. Between 1998 and 2003, SLNB was performed in 309 consecutive patients. Patients with one or more positive sentinel lymph nodes (SLNs) were subjected to selective lymphadenectomy (SL). Survival analyses were performed using the Kaplan-Meier approach. A Cox proportional-hazard analysis was used for univariate and multivariate analysis to explore the effect of variables on survival. Sentinel lymph nodes were identified in 299 of 309 patients (success rate: 96.8%). Of these, 69 (23%) had a positive SLN. The false-negative rate was 9.2%. Recurrence of disease to the regional lymph node basin (3.0%) and to the locoregional skin (2.6%) was rare in SLN-negative patients in contrast to SLN-positive patients (7.2 and 17.4%, respectively). The 3-year overall survival was 93 and 83% for SLN-negative and SLN-positive patients, respectively. Upon multivariate analysis, SLN status (P<0.001), Breslow thickness (P<0.02) and ulceration (P<0.026) were all found to be independent prognostic factors with respect to disease-free survival, whereas Breslow thickness proved to be the only significant factor with respect to overall survival.
- Subjects :
- Adult
Aged
Aged, 80 and over
Analysis of Variance
Disease-Free Survival
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Risk Factors
Sentinel Lymph Node Biopsy
Survival Analysis
Lymph Nodes pathology
Melanoma mortality
Melanoma pathology
Skin Neoplasms mortality
Skin Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 0007-0920
- Volume :
- 92
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- British journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 15700039
- Full Text :
- https://doi.org/10.1038/sj.bjc.6602391