Clinical Considerations on Sentinel Node Biopsy in Melanoma from an Italian Multicentric Study on 1,313 Patients (SOLISM–IMI) View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-07

AUTHORS

Alessandro Testori, Gian Luca De Salvo, Maria Cristina Montesco, Giuseppe Trifirò, Simone Mocellin, Giorgio Landi, Giuseppe Macripò, Paolo Carcoforo, Giuseppe Ricotti, Giuseppe Giudice, Franco Picciotto, Davide Donner, Franco Di Filippo, Javier Soteldo, Dario Casara, Mauro Schiavon, Antonella Vecchiato, Sandro Pasquali, Federica Baldini, Giovanni Mazzarol, Carlo Riccardo Rossi, on behalf of the Italian Melanoma Intergroup (IMI)

ABSTRACT

BACKGROUND: Although widely used for the management of patients with cutaneous melanoma, the sentinel lymph node (SLN) biopsy (SNB) procedure raises several issues. This study was designed to investigate: the predictive factors of SLN status, the false-negative (FN) rate, and patients' prognosis after SNB. PATIENTS AND METHODS: This is an observational, prospective study conducted on a large series of consecutive patients (n = 1,313) enrolled by 23 Italian centers from 2000 through 2002. A commonly shared protocol was adopted for the SNB surgical procedure and the SLN pathological examination. RESULTS: The SLN positive and false-negative (FN) rates were 16.9% and 14.4%, respectively (median follow-up, 4.5 years). At multivariable logistic regression analysis, the frequency of positive SLN increased with increasing Breslow thickness (p < 0.0001) and decreased in patients with melanoma regression (p = 0.024). At the multivariable Cox regression analysis, SLN status was the most important prognostic factor (hazards ratio (HR) = 3.08) for overall survival; the other statistically significant factors were sex, age, Breslow thickness, and Clark's level. Considering SLN and NSLN status, including FN cases, we identified four groups of patients with different prognoses. The 5-year overall survival of patients with positive SLNs was 71.3% in those with negative nonsentinel lymph nodes (NSLNs) and 50.4% if NSLNs were positive. CONCLUSIONS: Regression in the primary melanoma seems to be a protective factor from metastasis in the SLN. When correctly calculated, the SNB FN rate is 15-20%. Furthermore, the SNB is important to more precisely assess the prognosis of patients with melanoma. More... »

PAGES

2018-2027

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-008-0273-8

DOI

http://dx.doi.org/10.1245/s10434-008-0273-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1013946599

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19132446


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457 rdf:type schema:Organization
458 https://www.grid.ac/institutes/grid.5608.b schema:alternateName University of Padua
459 schema:name Department of Oncological and Surgical Sciences, Surgery Branch, University of Padova, Padova, Italy
460 rdf:type schema:Organization
461 https://www.grid.ac/institutes/grid.7644.1 schema:alternateName University of Bari Aldo Moro
462 schema:name Chirurgia Plastica, University of Bari, Bari, Italy
463 rdf:type schema:Organization
 




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