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Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study
Author(s) -
Boada Aram,
TejeraVaquerizo Antonio,
Ribero Simone,
Puig Susana,
MorenoRamírez David,
DescalzoGallego Miguel A.,
Fierro María T.,
Quaglino Pietro,
Carrera Cristina,
Malvehy Josep,
VidalSicart Sergi,
Bennássar Antoni,
Rull Ramón,
Alos Llucìa,
Requena Celia,
Bolumar Isidro,
Traves Víctor,
Pla Ángel,
FernándezFigueras María T.,
Ferrándiz Carlos,
Pascual Iciar,
Manzano José L.,
SánchezLucas Marina,
GiménezXavier Pol,
Ferrandiz Lara,
Nagore Eduardo
Publication year - 2017
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31078
Subject(s) - medicine , sentinel lymph node , biopsy , melanoma , hazard ratio , breslow thickness , confidence interval , propensity score matching , surgery , cancer , breast cancer , cancer research
The clinical value of sentinel lymph node (SLN) biopsy in thick melanoma patients (Breslow >4 mm) has not been sufficiently studied. The aim of the study is to evaluate whether SLN biopsy increases survival in patients with thick cutaneous melanoma, and, as a secondary objective, to investigate correlations between survival and lymph node status. We included 1,211 consecutive patients with thick melanomas (>4 mm) registered in the participating hospitals' melanoma databases between 1997 and 2015. Median follow‐up was 40 months. Of these patients, 752 were matched into pairs by propensity scores based on sex, age, tumor location, histologic features of melanoma, year of diagnosis, hospital and adjuvant interferon therapy. The SLN biopsy vs . observation was associated with better DFS [adjusted hazard ratio (AHR), 0.74; 95% confidence interval (CI) 0.61–0.90); p = 0.002] and OS (AHR, 0.75; 95% CI, 0.60–0.94; p = 0.013) but not MSS (AHR, 0.84; 95% CI, 0.65–1.08; p = 0.165). SLN‐negative patients had better 5‐ and 10‐year MSS compared with SLN‐positive patients (65.4 vs . 51.9% and 48.3 vs . 38.8%; p = 0.01, respectively). As a conclusion, SLN biopsy was associated with better DFS but not MSS in thick melanoma patients after adjustment for classic prognostic factors. SLN biopsy is useful for stratifying these patients into different prognostic groups.