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.
Prognostic impact of regression in patients with primary cutaneous melanoma >1 mm in thickness / Ribero, Simone; Galli, Francesca; Osella-Abate, Simona; Bertero, Luca; Cattaneo, Laura; Merelli, Barbara; Tondini, Carlo; Ghilardi, Laura; De Giorgi, Vincenzo; Occelli, Marcella; Quaglino, Pietro; Cassoni, Paola; Palmieri, Giuseppe; Massi, Daniela; Mandala, Mario; Queirolo, Paola; Stanganelli, Ignazio; Botti, Gerardo; Caracò, Corrado; Chiarion Sileni, Vanna; Di Giacomo, Anna Maria. - In: JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY. - ISSN 0190-9622. - 80:1(2019), pp. 99-105.e5. [10.1016/j.jaad.2018.06.054]
Prognostic impact of regression in patients with primary cutaneous melanoma >1 mm in thickness
Stanganelli, IgnazioMembro del Collaboration Group
;
2019-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.