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V2 与风相奔跑 声望 20 2个月前 上传
Effects of time interval between primary melanoma excision and sentinel node biopsy on positivity rate and survival
Abstract Background Sentinel node biopsy (SNB) is essential for adequate melanoma staging. Most melanoma guidelines advocate to perform wide local excision and SNB as soon as possible, causing time pressure. Objective To investigate the role of time interval between melanoma diagnosis and SNB on sentinel node (SN) positivity and survival. Methods This is a retrospective observational study concerning a cohort of melanoma patients from four European Organization for Research and Treatment of Cancer Melanoma Group tertiary referral centres from 1997 to 2013. A total of 4124 melanoma patients underwent SNB. Patients were selected if date of diagnosis and follow-up (FU) information were available, and SNB was performed in 43 d): 19.7% versus 20.1% (p = 0.771). Median FU was 50 months (IQR 24–84 months). Sentinel node metastasis (hazard ratio [HR] 3.17, 95% confidence interval [95% CI] 2.53–3.97), ulceration (HR 1.99, 95% CI 1.58–2.51), Breslow thickness (HR 1.06, 95% CI 1.04–1.08), and male gender (HR 1.58, 95% CI 1.26–1.98) (all p < 0.00001) were independently associated with worse MSS and DFS; time interval was not. Interpretation No effect of time interval between melanoma diagnosis and SNB on 5-year survival or SN positivity rate was found for a time interval of up to 3 months. This information can be used to counsel patients and remove strict time limits from melanoma guidelines.

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