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Is sentinel lymph node biopsy needed for lentigo maligna melanoma?
Kakish, Hanna; Lal, Trisha; Thuener, Jason E; Bordeaux, Jeremy S; Mangla, Ankit; Rothermel, Luke D; Hoehn, Richard S.
Afiliação
  • Kakish H; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
  • Lal T; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
  • Thuener JE; Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
  • Bordeaux JS; Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
  • Mangla A; Division of Hematology and Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
  • Rothermel LD; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
  • Hoehn RS; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
J Surg Oncol ; 129(4): 804-812, 2024 Mar.
Article em En | MEDLINE | ID: mdl-38018361
BACKGROUND AND OBJECTIVES: Sentinel lymph node biopsy (SLNB) is an area of debate in the management of lentigo maligna melanoma (LMM). The utility of SLNB and its prognostic value in LMM have not yet been studied with large databases. METHODS: We performed a retrospective review of the National Cancer Database (2012-2020) and the Surveillance, Epidemiology, and End Results (2010-2019) database for patients with cutaneous nonmetastatic LMM with Breslow thickness >1.0 mm. Multivariable logistic regression identified factors associated with SLNB performance and sentinel lymph node (SLN) positivity. Univariable and multivariable analyses assessed overall survival (OS) and melanoma-specific survival (MSS) based on SLNB performance and SLN status. RESULTS: Compared to other melanoma subtypes, LMM had lower rates of SLNB (66.6% vs. 80.0%-84.0%) and SLN positivity (11.3% vs. 18.6%-34.2%). Compared to patients who did not undergo SLNB, SLN status was significantly associated with improved OS in patients with SLN positive (HR = 0.64 [0.55-0.76]) and SLN negative (HR = 0.68 [0.49-0.94]), and worse MSS only in patients with positive SLN (HR = 3.93, p < 0.05). CONCLUSION: The improved OS associated with SLNB likely implies surgical selection bias. Analysis of MSS confirms appropriate patient selection and suggests important prognostic value associated with SLN status. These results support continued SLNB for LMM patients according to standard guidelines.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Sarda Melanótica de Hutchinson / Linfonodo Sentinela / Melanoma Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Sarda Melanótica de Hutchinson / Linfonodo Sentinela / Melanoma Idioma: En Ano de publicação: 2024 Tipo de documento: Article