Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy
Sentinel lymph node biopsy (SLNB) is a standard procedure in the management of clinically node-negative melanoma. However, few studies have been performed on SLNB in Asia, which is an acral melanoma-prevalent area. This study evaluated the clinicopathologic prognostic factors of disease-free surviva...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2015-05-01
|
| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664613002222 |
| _version_ | 1818129038399504384 |
|---|---|
| author | Chiao-En Wu Chia-Hsun Hsieh Cheng-Jen Chang Jiun-Ting Yeh Tseng-Tong Kuo Chih-Hsun Yang Yung-Feng Lo Kun-Ju Lin Yung-Chang Lin John Wen-Cheng Chang |
| author_facet | Chiao-En Wu Chia-Hsun Hsieh Cheng-Jen Chang Jiun-Ting Yeh Tseng-Tong Kuo Chih-Hsun Yang Yung-Feng Lo Kun-Ju Lin Yung-Chang Lin John Wen-Cheng Chang |
| author_sort | Chiao-En Wu |
| collection | DOAJ |
| description | Sentinel lymph node biopsy (SLNB) is a standard procedure in the management of clinically node-negative melanoma. However, few studies have been performed on SLNB in Asia, which is an acral melanoma-prevalent area. This study evaluated the clinicopathologic prognostic factors of disease-free survival (DFS) and overall survival (OS) in Taiwanese patients with cutaneous melanoma who received wide excision and SLNB. The prognosis of patients with false-negative (FN) SLNB was also evaluated.
Methods: Malignant melanoma cases were reviewed for 518 patients who were treated between January 2000 and December 2011. Of these patients, 127 patients with node-negative cutaneous melanoma who received successful SLNB were eligible for inclusion in the study.
Results: The SLNB-positive rate was 34.6%. The median DFS was 51.5 months, and the median OS was 90.9 months at the median follow-up of 36.6 months. Multivariate analysis revealed that patients whose melanoma had a Breslow thickness greater than 2 mm had a significantly shorter DFS than patients whose melanoma had a Breslow thickness of 2 mm or less [hazard ratio (HR), 3.421; p = 0.005]. Independent prognostic factors of OS were a Breslow thickness greater than 2 mm (HR, 4.435; p = 0.002); nonacral melanoma (HR, 3.048; p = 0.001); and an age older than 65 years (HR, 2.819; p = 0.036). During the follow-up period, 13 of 83 SLN-negative patients developed a regional nodal recurrence. The SLNB failure rate was 15.7% and the FN rate was 22.8%. Compared to patients with a true-positive SLNB, patients with FN SLNB had a significantly shorter DFS (p = 0.001) but no significant difference in OS (p = 0.262).
Conclusion: Except for the pathologic subtypes, prognostic factors in Taiwan are similar to those used in other melanoma-prevalent countries. Identifying and closely monitoring patients at risk of nodal recurrence after a negative SLNB is important. |
| first_indexed | 2024-12-11T07:42:47Z |
| format | Article |
| id | doaj.art-4242424cd0f8420cbad35d3c6a18bb07 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-11T07:42:47Z |
| publishDate | 2015-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-4242424cd0f8420cbad35d3c6a18bb072022-12-22T01:15:31ZengElsevierJournal of the Formosan Medical Association0929-66462015-05-01114541542110.1016/j.jfma.2013.06.018Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsyChiao-En Wu0Chia-Hsun Hsieh1Cheng-Jen Chang2Jiun-Ting Yeh3Tseng-Tong Kuo4Chih-Hsun Yang5Yung-Feng Lo6Kun-Ju Lin7Yung-Chang Lin8John Wen-Cheng Chang9Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Plastic and Reconstructive Surgery, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Plastic and Reconstructive Surgery, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Pathology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Dermatology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Breast Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Nuclear Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanSentinel lymph node biopsy (SLNB) is a standard procedure in the management of clinically node-negative melanoma. However, few studies have been performed on SLNB in Asia, which is an acral melanoma-prevalent area. This study evaluated the clinicopathologic prognostic factors of disease-free survival (DFS) and overall survival (OS) in Taiwanese patients with cutaneous melanoma who received wide excision and SLNB. The prognosis of patients with false-negative (FN) SLNB was also evaluated. Methods: Malignant melanoma cases were reviewed for 518 patients who were treated between January 2000 and December 2011. Of these patients, 127 patients with node-negative cutaneous melanoma who received successful SLNB were eligible for inclusion in the study. Results: The SLNB-positive rate was 34.6%. The median DFS was 51.5 months, and the median OS was 90.9 months at the median follow-up of 36.6 months. Multivariate analysis revealed that patients whose melanoma had a Breslow thickness greater than 2 mm had a significantly shorter DFS than patients whose melanoma had a Breslow thickness of 2 mm or less [hazard ratio (HR), 3.421; p = 0.005]. Independent prognostic factors of OS were a Breslow thickness greater than 2 mm (HR, 4.435; p = 0.002); nonacral melanoma (HR, 3.048; p = 0.001); and an age older than 65 years (HR, 2.819; p = 0.036). During the follow-up period, 13 of 83 SLN-negative patients developed a regional nodal recurrence. The SLNB failure rate was 15.7% and the FN rate was 22.8%. Compared to patients with a true-positive SLNB, patients with FN SLNB had a significantly shorter DFS (p = 0.001) but no significant difference in OS (p = 0.262). Conclusion: Except for the pathologic subtypes, prognostic factors in Taiwan are similar to those used in other melanoma-prevalent countries. Identifying and closely monitoring patients at risk of nodal recurrence after a negative SLNB is important.http://www.sciencedirect.com/science/article/pii/S0929664613002222acral lentiginous melanomacutaneous melanomamalignant melanomaprognostic factorssentinel lymph node biopsy |
| spellingShingle | Chiao-En Wu Chia-Hsun Hsieh Cheng-Jen Chang Jiun-Ting Yeh Tseng-Tong Kuo Chih-Hsun Yang Yung-Feng Lo Kun-Ju Lin Yung-Chang Lin John Wen-Cheng Chang Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy Journal of the Formosan Medical Association acral lentiginous melanoma cutaneous melanoma malignant melanoma prognostic factors sentinel lymph node biopsy |
| title | Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy |
| title_full | Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy |
| title_fullStr | Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy |
| title_full_unstemmed | Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy |
| title_short | Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy |
| title_sort | prognostic factors for taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy |
| topic | acral lentiginous melanoma cutaneous melanoma malignant melanoma prognostic factors sentinel lymph node biopsy |
| url | http://www.sciencedirect.com/science/article/pii/S0929664613002222 |
| work_keys_str_mv | AT chiaoenwu prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT chiahsunhsieh prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT chengjenchang prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT jiuntingyeh prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT tsengtongkuo prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT chihhsunyang prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT yungfenglo prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT kunjulin prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT yungchanglin prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy AT johnwenchengchang prognosticfactorsfortaiwanesepatientswithcutaneousmelanomaundergoingsentinellymphnodebiopsy |