Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma

Antonio Tejera-Vaquerizo, Eduardo Nagore, Susana Puig, Caroline Robert, Philippe Saiag, Paula Martín-Cuevas, Elena Gallego, Enrique Herrera-Acosta, José Aguilera, Josep Malvehy, Cristina Carrera, Andrea Cavalcanti, Ramón Rull, Antonio Vilalta-Solsona, Emilie Lannoy, Celine Boutros, Naima Benannoune, Gorana Tomasic, Philippe Aegerte, Sergi Vidal-SicartJosep Palou, LLúcia Alos, Celia Requena, Víctor Traves, Ángel Pla, Isidro Bolumar, Virtudes Soriano, Carlos Guillén, Enrique Herrera-Ceballos

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    Abstract

    Abstract Introduction In patients with primary cutaneous melanoma, there is generally a delay between excisional biopsy of the primary tumour and sentinel-node biopsy. The objective of this study is to analyse the prognostic implications of this delay. Patients and method This was an observational, retrospective, cohort study in four tertiary referral hospitals. A total of 1963 patients were included. The factor of interest was the interval between the date of the excisional biopsy of the primary melanoma and the date of the sentinel-node biopsy (delay time) in the prognosis. The primary outcome was melanoma-specific survival and disease-free survival. Results A delay time of 40 days or less (hazard ratio (HR), 1.7; confidence interval (CI), 1.2-2.5) increased Breslow thickness (Breslow a≥2 mm, HR, >3.7; CI, 1.4-10.7), ulceration (HR, 1.6; CI, 1.1-2.3), sentinel-node metastasis (HR, 2.9; CI, 1.9-4.2), and primary melanoma localised in the head or neck were independently associated with worse melanoma-specific survival (all P < 0.03). The stratified analysis showed that the effect of delay time was at the expense of the patients with a negative sentinel-node biopsy and without regression. Conclusion Early sentinel-node biopsy is associated with worse survival in patients with cutaneous melanoma.

    Original languageEnglish
    Article number9496
    Pages (from-to)1780-1793
    Number of pages14
    JournalEuropean Journal of Cancer
    Volume51
    Issue number13
    DOIs
    Publication statusPublished - 8 Aug 2015

    Keywords

    • Melanoma
    • Prognosis
    • Sentinel lymph node
    • Skin surgery
    • Waiting list

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