Sentinel node tumor burden in prediction of prognosis in melanoma patients

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Palve , J , Ylitalo , L , Luukkaala , T , Jernman , J & Korhonen , N 2020 , ' Sentinel node tumor burden in prediction of prognosis in melanoma patients ' , Clinical and Experimental Metastasis , vol. 37 , no. 2 , pp. 365-376 .

Title: Sentinel node tumor burden in prediction of prognosis in melanoma patients
Author: Palve, Johanna; Ylitalo, Leea; Luukkaala, Tiina; Jernman, Juha; Korhonen, Niina
Contributor organization: HUS Inflammation Center
Department of Dermatology, Allergology and Venereology
Date: 2020-04
Language: eng
Number of pages: 12
Belongs to series: Clinical and Experimental Metastasis
ISSN: 0262-0898
Abstract: Recent data have demonstrated no survival benefit to immediate completion lymph node dissection (CLND) for positive sentinel node (SN) disease in melanoma. It is important to identify parameters in positive SNs, which predict prognosis in melanoma patients. These might provide prognostic value in staging systems and risk models by guiding high-risk patients' adjuvant therapy in clinical practice. In this retrospective study of university hospital melanoma database we analyzed tumor burden and prognosis in patients with positive SNs. Patients were stratified by the diameter of tumor deposit, distribution of metastatic focus in SN, ulceration and number of metastatic SNs. These were incorporated in Cox proportional hazard regression models. Predictive ability was assessed using Akaike information criterion and Harrell's concordance index. A total of 110 patients had positive SN and 104 underwent CLND. Twenty-two (21%) patients had non-SN metastatic disease on CLND. The 5-year melanoma specific survival for CLND-negative patients was 5.00 years (IQR 3.23-5.00, range 0.72-5.00) compared to 3.69 (IQR 2.28-4.72, range 1.01-5.00) years in CLND-positive patients (HR 2.82 (95% CI 1.17-6.76, p = 0.020).The models incorporating distribution of metastatic focus and the largest tumor deposit in SN had highest predictive ability. According to Cox proportional hazard regression models, information criterions and c-index, the diameter of tumor deposit > 4 mm with multifocal location in SN despite of number of metastatic SN were the most important parameters. According to the diameter of tumor deposit and distribution of metastatic focus in SN, adequate stratification of positive SN patients was possible and risk classes for patients were identified.
Subject: Melanoma
Prognosis in melanoma
Sentinel node-positive
Sentinel node tumor burden
3122 Cancers
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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