The effect of time to sentinel lymph node biopsy on cutaneous melanoma survival

Fortes, Cristina; Mastroeni, Simona; Caggiati, Alessio; Passarelli, Francesca; Zappalà, Alba; Capuano, M.; Bono, R.; Nudo, Maurizio; Marino, Claudia; Michelozzi, Paola

doi:10.1016/j.amjsurg.2016.02.025

Cited by 16 publications

(23 citation statements)

References 15 publications

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“…The authors postulated that early excision and SLNB can negatively affect development of anti-melanoma immunity. Conversely, in a recent series by Fortes and colleagues, 11 in which 748 patients with cutaneous melanoma underwent wide local excision and SLNB, the authors found that for patients with positive sentinel lymph nodes, delay times of less than 30 days were associated with a 3-fold decreased risk of melanoma mortality compared with patients with positive sentinel nodes whose surgery had been delayed more than 30 days. 11 …”

Section: Discussionmentioning

confidence: 94%

“…Such delays theoretically could affect outcomes, either adversely by allowing growth and dissemination of metastases or favorably by allowing development of an anti-melanoma immune responses. 8,11 …”

Section: Discussionmentioning

confidence: 99%

“…Previous series have examined delay times with cutoffs varying among 30, 40, 43, and 47 days, which reflected median “delay” before surgery for the respective study populations in those series. 7–11 Initial exploratory analysis of our cohort revealed a median delay from initial diagnosis to definitive wide local excision and SLNB of 27 days (mean 31.8 days; range 0 to 182 days). Stratified by 30-day intervals, 57.9% (n = 1,437) underwent SLNB less than 30 days from the time of initial diagnosis, 34.7% (n = 861) between 30 and 59 days, 4.8% (n = 120) between 60 and 89 days, and 2.6% (n = 65) at 90 days or more from the time of initial diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…However, existing outcomes data on the effect of delaying initial surgical treatment are mixed and contradictory. 7–11 …”

mentioning

confidence: 99%

“…8,11 Currently, existing data on the effect of SLNB delay on patient survival are conflicting. Therefore, our objective was to determine whether modest delay between diagnosis and SLNB affects outcomes in patients with cutaneous melanoma.…”

mentioning

confidence: 99%

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Impact of Time Between Diagnosis and SLNB on Outcomes in Cutaneous Melanoma

Nelson

Stern

Elashoff

et al. 2017

Journal of the American College of Surgeons

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BACKGROUND Hypothetically, delay between melanoma diagnosis and SLNB could affect outcomes, either adversely by allowing growth and dissemination of metastases, or beneficially by allowing development of an anti-melanoma immune response. Available data are conflicting about the effect of SLNB delay on patient survival. Our objective was to determine whether delay between initial diagnosis and SLNB affects outcomes in patients with cutaneous melanoma. STUDY DESIGN We performed query and analysis of a large prospectively maintained database of patients with primary cutaneous melanomas undergoing SLNB. An independent dataset from MSLT-1 (Multicenter Selective Lymphadenectomy Trial-1) was used for validation. Primary outcomes included disease-free survival and melanoma-specific survival. RESULTS Early and delayed SLNB were defined as less than 30 and 30 or more days from initial diagnosis, respectively. There were 2,483 patients that met inclusion criteria. Positive sentinel lymph nodes were identified in 17.4% (n = 432). Among all patients, 42% had SLNB 30 or more days after diagnosis and 37% of positive sentinel lymph nodes were at 30 or more days. No differences in sex, anatomic site, or histopathologic features were identified between the 2 groups. There was no difference in melanoma-specific survival or disease-free survival between those undergoing early or delayed SLNB. Examination of MSLT-1 trial data similarly demonstrated no difference in survival outcomes. CONCLUSIONS This, the largest study on this subject to date, found no adverse impact on long-term clinical outcomes of patients due to delay of SLNB beyond 30 days. The MSLT-1 data confirm this result. Patients can be reassured that if the operation is performed 30 or more days after diagnosis, it will not cause harm.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…However, existing outcomes data on the effect of delaying initial surgical treatment are mixed and contradictory. 7–11 …”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Impact of Time Between Diagnosis and SLNB on Outcomes in Cutaneous Melanoma

Nelson

Stern

Elashoff

et al. 2017

Journal of the American College of Surgeons

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Timing of completion lymphadenectomy after positive sentinel node biopsy in patients with melanoma

Ophuis

Akkooi

Rutkowski

et al. 2017

British Journal of Surgery

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Patterns of recurrence and retreatment outcomes among clinical stage I and II head and neck melanoma patients

et al. 2019

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Background The objective of this study was to determine survival outcomes in patients who underwent retreatment of recurrent cases of cutaneous melanoma of the head and neck (CMHN). Methods Retrospective review of all patients who were treated for primary clinical stage I or II CMHN between January 1, 2000 and December 31, 2015. Results Twenty percent (33/168) of the patients developed a recurrence. Sixty‐six percent (4/6) of patients who developed local recurrence first and 50% (3/6) of patients who developed regional recurrence first were alive without evidence (NED) of disease at last follow‐up, while 0% (0/21) of patients who developed distant or simultaneous recurrences first were NED at last follow‐up. Among the 7 patients who were NED, the mean time from recurrence to last follow‐up was 735 days. Conclusions Of patients with isolated local or regional recurrences, 58% (7/12) obtained durable curative treatment for recurrent melanoma.

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The effect of time to sentinel lymph node biopsy on cutaneous melanoma survival

Cited by 16 publications

References 15 publications

Impact of Time Between Diagnosis and SLNB on Outcomes in Cutaneous Melanoma

Impact of Time Between Diagnosis and SLNB on Outcomes in Cutaneous Melanoma

Timing of completion lymphadenectomy after positive sentinel node biopsy in patients with melanoma

Patterns of recurrence and retreatment outcomes among clinical stage I and II head and neck melanoma patients

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