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06.10.2022 | Melanoma

Is a History of Optimal Staging by Sentinel Lymph Node Biopsy in the Era Prior to Adjuvant Therapy Associated with Improved Outcome Once Melanoma Patients have Progressed to Advanced Disease?

verfasst von: Stephanie A. Blankenstein, MD, Johannes J. Bonenkamp, MD, Maureen J. B. Aarts, MD, Franchette W. P. J. van den Berkmortel, MD, PhD, Christian U. Blank, MD, PhD, Willeke A. M. Blokx, MD, PhD, Marye J. Boers-Sonderen, MD, PhD, Alfons J. M. van den Eertwegh, MD, PhD, Margreet G. Franken, PhD, Jan Willem B. de Groot, MD, PhD, John B. A. G. Haanen, MD, PhD, Geke A. P. Hospers, MD, PhD, Ellen W. Kapiteijn, MD, PhD, Olivier J. van Not, MD, Djura Piersma, MD, PhD, Rozemarijn S. van Rijn, MD, PhD, Karijn P. M. Suijkerbuijk, MD, PhD, Astrid A. M. van der Veldt, MD, PhD, Gerard Vreugdenhil, MD, Hans M. Westgeest, MD, Michel W. J. M. Wouters, MD, PhD, Alexander C. J. van Akkooi, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 1/2023

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Abstract

Introduction

Sentinel lymph node biopsy (SLNB) is important for staging in patients with primary cutaneous melanoma. Did having previously undergone SLNB also affect outcomes in patients once they have progressed to metastatic melanoma in the era prior to adjuvant therapy?

Methods

Data were retrieved from the Dutch Melanoma Treatment Registry, a prospectively collected, nationwide database of patients with unresectable stage IIIC or IV (advanced) melanoma between 2012 and 2018. Melanoma-specific survival (MSS) was compared between patients with advanced cutaneous melanoma, previously treated with a wide local excision (WLE) or WLE combined with SLNB as initial treatment of their primary tumor. Cox regression analyses were used to analyze the influence of different variables on MSS.

Results

In total, 2581 patients were included, of whom 1412 were treated with a WLE of the primary tumor alone and 1169 in whom this was combined with SLNB. At a median follow-up of 44 months from diagnosis of advanced melanoma, MSS was significantly longer in patients who had previously undergone SLNB {median 23 months (95% confidence interval [CI] 19–29) vs. 18 months (95% CI 15–20) for patients treated with WLE alone; p = 0.002}. However, multivariate Cox regression did not identify SLNB as an independent favorable prognostic factor for MSS after diagnosis of advanced melanoma.

Conclusion

Prior to the availability of adjuvant systemic therapy, once patients have unresectable stage IIIC or IV (advanced) melanoma, there was no difference in disease outcome for patients who were or were not previously staged with SLNB.

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Titel: Is a History of Optimal Staging by Sentinel Lymph Node Biopsy in the Era Prior to Adjuvant Therapy Associated with Improved Outcome Once Melanoma Patients have Progressed to Advanced Disease?
verfasst von: Stephanie A. Blankenstein, MD
Johannes J. Bonenkamp, MD
Maureen J. B. Aarts, MD
Franchette W. P. J. van den Berkmortel, MD, PhD
Christian U. Blank, MD, PhD
Willeke A. M. Blokx, MD, PhD
Marye J. Boers-Sonderen, MD, PhD
Alfons J. M. van den Eertwegh, MD, PhD
Margreet G. Franken, PhD
Jan Willem B. de Groot, MD, PhD
John B. A. G. Haanen, MD, PhD
Geke A. P. Hospers, MD, PhD
Ellen W. Kapiteijn, MD, PhD
Olivier J. van Not, MD
Djura Piersma, MD, PhD
Rozemarijn S. van Rijn, MD, PhD
Karijn P. M. Suijkerbuijk, MD, PhD
Astrid A. M. van der Veldt, MD, PhD
Gerard Vreugdenhil, MD
Hans M. Westgeest, MD
Michel W. J. M. Wouters, MD, PhD
Alexander C. J. van Akkooi, MD, PhD
Publikationsdatum: 06.10.2022
Verlag: Springer International Publishing
Erschienen in: Annals of Surgical Oncology / Ausgabe 1/2023
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-022-12600-2

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Is a History of Optimal Staging by Sentinel Lymph Node Biopsy in the Era Prior to Adjuvant Therapy Associated with Improved Outcome Once Melanoma Patients have Progressed to Advanced Disease?