Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma
Menée sur 1 963 patients atteints d'un mélanome cutané, cette étude évalue l'effet du délai entre l'exérèse du mélanome et la biopsie du ganglion sentinelle sur la survie des patients
Introduction : In patients with primary cutaneous melanoma, there is generally a delay between excisional biopsy of the primary tumour and sentinel-node biopsy. The objective of this study is to analyse the prognostic implications of this delay.
Patients and method : This was an observational, retrospective, cohort study in four tertiary referral hospitals. A total of 1963 patients were included. The factor of interest was the interval between the date of the excisional biopsy of the primary melanoma and the date of the sentinel-node biopsy (delay time) in the prognosis. The primary outcome was melanoma-specific survival and disease-free survival.
Results : A delay time of 40 days or less (hazard ratio (HR), 1.7; confidence interval (CI), 1.2–2.5) increased Breslow thickness (Breslow ⩾2 mm, HR, >3.7; CI, 1.4–10.7), ulceration (HR, 1.6; CI, 1.1–2.3), sentinel-node metastasis (HR, 2.9; CI, 1.9–4.2), and primary melanoma localised in the head or neck were independently associated with worse melanoma-specific survival (all P < 0.03). The stratified analysis showed that the effect of delay time was at the expense of the patients with a negative sentinel-node biopsy and without regression.
Conclusion : Early sentinel-node biopsy is associated with worse survival in patients with cutaneous melanoma.
European Journal of Cancer , résumé, 2014