Oude Ophuis, CMC;
Verhoef, C;
Rutkowski, P;
Powell, BWEM;
van der Hage, JA;
van Leeuwen, PAM;
Voit, CA;
Testori, A;
Robert, C;
Hoekstra, HJ;
et al.
Oude Ophuis, CMC; Verhoef, C; Rutkowski, P; Powell, BWEM; van der Hage, JA; van Leeuwen, PAM; Voit, CA; Testori, A; Robert, C; Hoekstra, HJ; Grünhagen, DJ; Eggermont, AMM; van Akkooi, ACJ
(2016)
The interval between primary melanoma excision and sentinel node biopsy is not associated with survival in sentinel node positive patients - An EORTC Melanoma Group study.
Eur J Surg Oncol, 42 (12).
pp. 1906-1913.
ISSN 1532-2157
https://doi.org/10.1016/j.ejso.2016.05.012
SGUL Authors: Powell, Barry
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Abstract
BACKGROUND: Worldwide, sentinel node biopsy (SNB) is the recommended staging procedure for stage I/II melanoma. Most melanoma guidelines recommend re-excision plus SNB as soon as possible after primary excision. To date, there is no evidence to support this timeframe. AIM: To determine melanoma specific survival (MSS) for time intervals between excisional biopsy and SNB in SNB positive patients. METHODS: Between 1993 and 2008, 1080 patients were diagnosed with a positive SNB in nine Melanoma Group centers. We selected 1015 patients (94%) with known excisional biopsy date. Time interval was calculated from primary excision until SNB. Kaplan-Meier estimated MSS was calculated for different cutoff values. Multivariable analysis was performed to correct for known prognostic factors. RESULTS: Median age was 51 years (Inter Quartile Range (IQR) 40-62 years), 535 (53%) were men, 603 (59%) primary tumors were located on extremities. Median Breslow thickness was 3.00 mm (IQR 1.90-4.80 mm), 442 (44%) were ulcerated. Median follow-up was 36 months (IQR 20-62 months). Median time interval was 47 days (IQR 32-63 days). Median Breslow thickness was equal for both <47 days and ≥47 days interval: 3.00 mm (1.90-5.00 mm) vs 3.00 mm (1.90-4.43 mm) (p = 0.402). Sentinel node tumor burden was significantly higher in patients operated ≥47 days (p = 0.005). Univariate survival was not significantly different for median time interval. Multivariable analysis confirmed that time interval was no independent prognostic factor for MSS. CONCLUSIONS: Time interval from primary melanoma excision until SNB was no prognostic factor for MSS in this SNB positive cohort. This information can be used to counsel patients.
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