Prognostic value of sentinel node biopsy in 327 prospective melanoma patients from a single institution

Details

Serval ID
serval:BIB_081561D6486A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prognostic value of sentinel node biopsy in 327 prospective melanoma patients from a single institution
Journal
European Journal of Surgical Oncology
Author(s)
Roulin D., Matter M., Bady P., Lienard D., Gugerli O., Boubaker A., Bron L., Lejeune F. J.
ISSN
1532-2157
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
34
Number
6
Pages
673-679
Language
english
Abstract
AIM: To confirm the accuracy of sentinel node biopsy (SNB) procedure and its morbidity, and to investigate predictive factors for SN status and prognostic factors for disease-free survival (DFS) and disease-specific survival (DSS). MATERIALS AND METHODS: Between October 1997 and December 2004, 327 consecutive patients in one centre with clinically node-negative primary skin melanoma underwent an SNB by the triple technique, i.e. lymphoscintigraphy, blue-dye and gamma-probe. Multivariate logistic regression analyses as well as the Kaplan-Meier were performed. RESULTS: Twenty-three percent of the patients had at least one metastatic SN, which was significantly associated with Breslow thickness (p<0.001). The success rate of SNB was 99.1% and its morbidity was 7.6%. With a median follow-up of 33 months, the 5-year DFS/DSS were 43%/49% for patients with positive SN and 83.5%/87.4% for patients with negative SN, respectively. The false-negative rate of SNB was 8.6% and sensitivity 91.4%. On multivariate analysis, DFS was significantly worsened by Breslow thickness (RR=5.6, p<0.001), positive SN (RR=5.0, p<0.001) and male sex (RR=2.9, p=0.001). The presence of a metastatic SN (RR=8.4, p<0.001), male sex (RR=6.1, p<0.001), Breslow thickness (RR=3.2, p=0.013) and ulceration (RR=2.6, p=0.015) were significantly associated with a poorer DSS. CONCLUSION: SNB is a reliable procedure with high sensitivity (91.4%) and low morbidity. Breslow thickness was the only statistically significant parameter predictive of SN status. DFS was worsened in decreasing order by Breslow thickness, metastatic SN and male gender. Similarly DSS was significantly worsened by a metastatic SN, male gender, Breslow thickness and ulceration. These data reinforce the SN status as a powerful staging procedure
Keywords
Adolescent , Adult , adverse effects , Aged , Aged,80 and over , analysis , Biopsy , Female , Humans , Logistic Models , Lymphatic Metastasis , Male , Melanoma , methods , Middle Aged , Multivariate Analysis , pathology , Patient Selection , Patients , Prospective Studies , Risk Factors , secondary , Sensitivity and Specificity , Sentinel Lymph Node Biopsy , Sex , Skin , Skin Neoplasms , surgery , Survival , Survival Analysis , Switzerland
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2009 22:14
Last modification date
20/08/2019 12:30
Usage data