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Eur J Surg Oncol. 2016 Dec;42(12):1906-1913. doi: 10.1016/j.ejso.2016.05.012. Epub 2016 May 27.

The interval between primary melanoma excision and sentinel node biopsy is not associated with survival in sentinel node positive patients - An EORTC Melanoma Group study.

Author information

1
Department of Surgical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands. Electronic address: c.oudeophuis@erasmusmc.nl.
2
Department of Surgical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands. Electronic address: c.verhoef@erasmusmc.nl.
3
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, ul. W.K. Roentgena 5, 02-781 Warsaw, Poland. Electronic address: rutkowskip@coi.waw.pl.
4
Melanoma Unit, St. George's Foundation University Hospital, Blakshaw Road, Tooting, London SW17 0QT, United Kingdom. Electronic address: bpowell@sgul.ac.uk.
5
Department of Surgery, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Electronic address: j.vd.hage@nki.nl.
6
Department of Surgical Oncology, Vrije Universiteit Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: pam.vleeuwen@vumc.nl.
7
Department of Dermatology, Charité, University of Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany.
8
Division of Dermato Oncological Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. Electronic address: alessandro.testori@ieo.it.
9
Department of Dermatology, Cancer Institute Gustave Roussy, 114 rue Édouard-Vaillant, 94805 Villejuif, France. Electronic address: caroline.robert@igr.fr.
10
Department of Surgical Oncology, Groningen University, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: h.j.hoekstra@umcg.nl.
11
Department of Surgical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands. Electronic address: d.grunhagen@erasmusmc.nl.
12
Cancer Institute Gustave Roussy, 114 rue Édouard-Vaillant, 94805 Villejuif, France. Electronic address: alexander.eggermont@igr.fr.
13
Department of Surgery, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Electronic address: a.v.akkooi@nki.nl.

Abstract

BACKGROUND:

Worldwide, sentinel node biopsy (SNB) is the recommended staging procedure for stage I/II melanoma. Most melanoma guidelines recommend re-excision plus SNB as soon as possible after primary excision. To date, there is no evidence to support this timeframe.

AIM:

To determine melanoma specific survival (MSS) for time intervals between excisional biopsy and SNB in SNB positive patients.

METHODS:

Between 1993 and 2008, 1080 patients were diagnosed with a positive SNB in nine Melanoma Group centers. We selected 1015 patients (94%) with known excisional biopsy date. Time interval was calculated from primary excision until SNB. Kaplan-Meier estimated MSS was calculated for different cutoff values. Multivariable analysis was performed to correct for known prognostic factors.

RESULTS:

Median age was 51 years (Inter Quartile Range (IQR) 40-62 years), 535 (53%) were men, 603 (59%) primary tumors were located on extremities. Median Breslow thickness was 3.00 mm (IQR 1.90-4.80 mm), 442 (44%) were ulcerated. Median follow-up was 36 months (IQR 20-62 months). Median time interval was 47 days (IQR 32-63 days). Median Breslow thickness was equal for both <47 days and ≥47 days interval: 3.00 mm (1.90-5.00 mm) vs 3.00 mm (1.90-4.43 mm) (p = 0.402). Sentinel node tumor burden was significantly higher in patients operated ≥47 days (p = 0.005). Univariate survival was not significantly different for median time interval. Multivariable analysis confirmed that time interval was no independent prognostic factor for MSS.

CONCLUSIONS:

Time interval from primary melanoma excision until SNB was no prognostic factor for MSS in this SNB positive cohort. This information can be used to counsel patients.

KEYWORDS:

Cutaneous melanoma; Melanoma; Melanoma specific survival; Prognosis; Sentinel lymph node biopsy; Waiting list

PMID:
27266406
DOI:
10.1016/j.ejso.2016.05.012
[Indexed for MEDLINE]

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