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Sentinel node status predicts survival in thick melanomas : the Oxford perspective
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Rughani, M. G., Swan, M. C., Adams, T. S., Marshall, A. (Andrea), Asher, R., Cassell, O. C. and Middleton, M. (Mark) (2012) Sentinel node status predicts survival in thick melanomas : the Oxford perspective. European Journal of Surgical Oncology (EJSO), Vol.38 (No.10). pp. 936-942. doi:10.1016/j.ejso.2012.04.011 ISSN 0748-7983.
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Official URL: http://dx.doi.org/10.1016/j.ejso.2012.04.011
Abstract
Aims
To determine the prognostic value of SLNB in patients with thick melanoma in terms of overall survival (OS) and recurrence-free survival (RFS).
Methods
136 patients with primary tumours (Breslow thickness ≥4.0 mm) underwent SLNB. OS and RFS were calculated and a multivariate Cox regression model used to determine the important prognostic factors for predicting OS and RFS.
Results
Median Breslow thickness was 5.5 mm and 60% were ulcerated. Median follow up was 4 years (95% CI = 4–5) with 54 patients having died at the time of analysis. 5-year OS for SLNB positive patients was 32%, compared to 78% for negative patients. The significant predictors of poorer OS were increasing age (p = 0.03), increasing Breslow thickness (p = 0.03) and SLNB positivity (p < 0.0001). 5 year RFS was significantly worse in the SLNB positive population compared to the negative patients (p < 0.0001); 27% versus 66% respectively.
Conclusions
Patients with a thick melanoma and a positive SLNB have a significantly worse RFS and OS compared to those with a negative SLNB. Over three-quarters of patients with a negative SLNB survived five years. These findings have implications for the subpopulations included in adjuvant therapy trials and we advocate SLNB be recommended in patients with thick melanomas.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | European Journal of Surgical Oncology (EJSO) | ||||
Publisher: | W.B. Saunders Co. Ltd. | ||||
ISSN: | 0748-7983 | ||||
Official Date: | 2012 | ||||
Dates: |
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Volume: | Vol.38 | ||||
Number: | No.10 | ||||
Page Range: | pp. 936-942 | ||||
DOI: | 10.1016/j.ejso.2012.04.011 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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