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Ann Surg Oncol. 2017 Aug;24(8):2089-2094. doi: 10.1245/s10434-017-5775-9. Epub 2017 Feb 21.

The Impact of Smoking on Sentinel Node Metastasis of Primary Cutaneous Melanoma.

Author information

1
Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
2
Department of Molecular Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
3
Department of Biostatistics, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
4
UCLA Department of Biostatistics, Los Angeles, CA, USA.
5
Melanoma Institute Australia, Sydney, NSW, Australia.
6
Istituto Nazionale dei Tumori Napoli, Napoli, Italy.
7
IHC Cancer Services, Intermountain Medical Center, Salt Lake City, UT, USA.
8
Universitair Medisch Centrum Groningen, Groningen, The Netherlands.
9
H. Lee Moffitt Cancer Center, Tampa, USA.
10
NYU Langone Medical Center, New York, USA.
11
Istituto Europeo di Oncologia, Milano, Italy.
12
Royal Adelaide Hospital Discipline of Surgery, Royal Adelaide HospitalUniversity of Adelaide, Adelaide, SA, Australia.
13
Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
14
Huntsman Cancer Institute, Salt Lake City, USA.
15
Ohio State University, Columbus, USA.
16
Nuremberg General Hospital - Paracelsus Medical University, Nuremberg, Germany.
17
Saint Louis University, St. Louis, USA.
18
Vanderbilt University, Nashville, USA.
19
Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
20
Johns Hopkins Medical Institute, Baltimore, USA.
21
California Pacific Medical Center, San Francisco, USA.
22
Department of Melanoma Research, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA. mark.faries@jwci.org.

Abstract

BACKGROUND:

Although a well-established causative relationship exists between smoking and several epithelial cancers, the association of smoking with metastatic progression in melanoma is not well studied. We hypothesized that smokers would be at increased risk for melanoma metastasis as assessed by sentinel lymph node (SLN) biopsy.

METHODS:

Data from the first international Multicenter Selective Lymphadenectomy Trial (MSLT-I) and the screening-phase of the second trial (MSLT-II) were analyzed to determine the association of smoking with clinicopathologic variables and SLN metastasis.

RESULTS:

Current smoking was strongly associated with SLN metastasis (p = 0.004), even after adjusting for other predictors of metastasis. Among 4231 patients (1025 in MSLT-I and 3206 in MSLT-II), current or former smoking was also independently associated with ulceration (p < 0.001 and p < 0.001, respectively). Compared with current smoking, never smoking was independently associated with decreased Breslow thickness in multivariate analysis (p = 0.002) and with a 0.25 mm predicted decrease in thickness.

CONCLUSION:

The direct correlation between current smoking and SLN metastasis of primary cutaneous melanoma was independent of its correlation with tumor thickness and ulceration. Smoking cessation should be strongly encouraged among patients with or at risk for melanoma.

PMID:
28224364
PMCID:
PMC5553293
DOI:
10.1245/s10434-017-5775-9
[Indexed for MEDLINE]
Free PMC Article

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