Prognostic impact of regression in patients with primary cutaneous melanoma >1 mm in thickness - 13/12/18
on behalf of the
Italian Melanoma Intergroup
Abstract |
Background |
The impact of histologic regression on sentinel lymph node biopsy (SLNB) status and on clinical outcome is uncertain.
Objective |
To investigate whether and to what extent regression <75% is able to predict SLNB status and clinical outcome of patients with melanoma >1-mm thick.
Methods |
The study included patients with diagnoses given at 4 centers of the Italian Melanoma Intergroup. Univariate and multivariate Cox proportional hazard models stratified by center were used to analyze the effect of regression on disease-free interval and melanoma-specific survival.
Results |
Out of 1182 patients given primary cutaneous melanoma diagnoses during 1998-2015 with a Breslow thickness >1 mm, 954 (304 with and 650 without regression) were included in the analysis. The proportion of patients with a positive SLNB was lower in patients with regression than without (24.4% vs 31.6%, chi-squared test P = .0368). At multivariate analysis, no association was detected between regression and disease-free interval (hazard ratio 1.11, 95% confidence interval 0.85-1.46; P = .4509) or melanoma-specific survival (hazard ratio 1.05, 95% confidence interval 0.77-1.44; P = .7600).
Limitation |
Retrospective analysis.
Conclusion |
In our series, regression was not an independent prognostic factor in primary cutaneous melanoma patients with Breslow thickness >1 mm whereas it was associated with a lower incidence of SLNB positivity.
Le texte complet de cet article est disponible en PDF.Key words : cutaneous melanoma, disease-free interval, melanoma-specific survival, outcome, prognosis, regression, sentinel lymph node
Abbreviations used : CAP, CI, DFI, HR, MSS, PCM, SD, SLN, SLNB, TIL
Plan
Dr Ribero and Ms Galli contributed equally to the manuscript. |
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Drs Massi and Mandala contributed equally to senior authorship. |
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Approval to conduct this study was obtained from the IMI Institutional Review Board and Local Ethical Committees. |
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Funding sources: Supported by the Italian Melanoma Intergroup (grant 3/2015); the Italian Network for Melanoma Treatment and Research (www.melanomaimi.it); Italian Ministry of Instruction, University, and Research project Dipartimenti di Eccellenza 2018–2022; and MIUR COFIN 2015 (prot. 2015HAJH8E). Lanzavecchia-Lastretti Foundation partially supported Dr Cassoni and Rete Oncologica Dr Ribero. |
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Conflicts of interest: None disclosed. |
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Reprints not available from the authors. |
Vol 80 - N° 1
P. 99 - janvier 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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