The sentinel node biopsy has not come of age

Sladden, Michael J; Zagarella, Samuel; Popescu, C; Bigby, Michael

doi:10.1111/bjd.18540

Cited by 4 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Improved Methodology In Determining Melanoma Mortality and S...mentioning

confidence: 99%

“…4 Sentinel lymph node biopsy status (SLNBS) might contribute only a marginal survival predictability above that of an algorithm of CAPP. 5,6 Until recently, no quality research has been available to test this hypothesis.El Sharouni et al (ESS) 7 recently detailed the prognostic value of CAPP, with or without SLNBS, for calculating overall survival (OS) for melanoma patients. Predictors including Breslow thickness, tumour, ulceration, patient age, sex, mitotic activity, regression, tumour subtype and location were evaluated in 9272 Dutch patients.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Improved methodology in determining melanoma mortality and selecting patients for immunotherapy

Dixon

Steinman

Kyrgidis

et al. 2023

Acad Dermatol Venereol

Self Cite

View full text Add to dashboard Cite

Improved methodology in determining melanoma mortality and selecting patients for immunotherapyDear Editor, Sentinel lymph node biopsy (SLNB) benefits are said to include identifying the presence and degree of micrometastases, improving staging, predicting prognosis and determining eligibility for adjuvant drug therapy. Sentinel lymph node biopsy is an invasive procedure, which needs nuclear medicine and operating room facilities. Neither SLNB nor early identification of micrometastases provides an overall survival benefit for melanoma patients. 1,2 Adverse events in the order of 11% are expected. 3 Predicting the likelihood of mortality can assist patient selection for adjuvant drug therapy. Breslow thickness, ulceration status and other clinical and pathologic predictors (CAPP) assist predicting melanoma survival. 4 Sentinel lymph node biopsy status (SLNBS) might contribute only a marginal survival predictability above that of an algorithm of CAPP. 5,6 Until recently, no quality research has been available to test this hypothesis.El Sharouni et al (ESS) 7 recently detailed the prognostic value of CAPP, with or without SLNBS, for calculating overall survival (OS) for melanoma patients. Predictors including Breslow thickness, tumour, ulceration, patient age, sex, mitotic activity, regression, tumour subtype and location were evaluated in 9272 Dutch patients. The findings were validated in 5644 Australian patients. 7 El Sharouni et al evaluated the accuracy of each CAPP in predicting OS using appropriate Area Under Curve (AUC) cstatistic methodology. 7 The higher the C-statistic, the better the model separates patients who will die from those who will not die. Combined CAPP was significantly superior to SLNBS at predicting OS. Combining SLNBS with CAPP increased c-statistic for OS by only 3%, with overlapping confidence intervals indicating an absence of statistical significance (Figure 1).El Sharouni et al found Breslow thickness to be the most accurate OS predictor followed by patient age. Subsequently, SLNBS and ulceration were similar. Mitotic activity and regression fell below 0.54, suggesting they might not provide relevant information 7 (Figure 2).El Sharouni et al also reported that SLNBS detected 1.4 more net high-risk melanoma patients (HRMP) for every 100 patients experiencing recurrence within 3 years when used in combination with CAPP. 7 Recurrence rates of approximately 13%-15% have been reported in HRMP. 8 Assuming

show abstract

Section: Improved Methodology In Determining Melanoma Mortality and S...mentioning

confidence: 99%

mentioning

confidence: 99%

Improved methodology in determining melanoma mortality and selecting patients for immunotherapy

Dixon

Steinman

Kyrgidis

et al. 2023

Acad Dermatol Venereol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Some clinicians have been cautious about or have disagreed with claims made about the role of SLNB in melanoma management. In particular, there has been disagreement over the claimed survival benefit and the prognostic benefit of SLNB over and above other readily available clinicopathological criteria of the primary melanoma 12–15 . Rates of SLNB in Australia and internationally have been reported to be between 33% and 53% 16–20 .…”

Section: Introductionmentioning

confidence: 99%

“…In particular, there has been disagreement over the claimed survival benefit and the prognostic benefit of SLNB over and above other readily available clinicopathological criteria of the primary melanoma. [12][13][14][15] Rates of SLNB in Australia and internationally have been reported to be between 33% and 53%. [16][17][18][19][20] A recent study reported the views of Australian general practitioners towards SLNB, 21 but there are limited data on Australian dermatologists' knowledge of and attitudes towards SLNB in the management of melanoma.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes of Australian dermatologists towards sentinel lymph node biopsy for melanoma: a mixed methods study

et al. 2020

View full text Add to dashboard Cite

Background/Objectives: In melanoma management, sentinel lymph node biopsy (SLNB) is used to stage patients and to indicate prognosis. More recently, it has been used to select patients for adjuvant therapy. This study aimed to report knowledge of and attitudes towards SLNB for patients with melanoma among Australian dermatologists.Methods: Mixed methods study using cross-sectional questionnaires (n = 88) and semi-structured interviews (n = 13), May-September 2019.Results: Of the dermatologists surveyed, 56% thought SLNB had an important role in melanoma management, 26% were unsure and 18% thought SLNB unimportant. Of the 92% who would discuss SLNB with their patients, the main stated value of SLNB was for assessing eligibility for adjuvant therapies (79%); only 60% indicated SLNB was of value for providing prognostic information, and just over half (53%) thought it could improve staging. Interview data indicated that attitudes towards SLNB are shifting among dermatologists, driven by data from landmark clinical trials and the influence of professional networks. Accordingly, interviewees adopted one of three positions in relation to SLNB: (a) believed in utility of SLNB and adhered to the guidelines; (b) were unconvinced about utility of SLNB but adhered to the guidelines; and (c) were unconvinced about utility of SLNB and did not adhere to the guidelines.

show abstract

Biopsia selectiva del ganglio centinela en melanoma: ni utilidad terapéutica, ni es buena para seleccionar los pacientes que podrían beneficiarse de la inmunoterapia adyuvante

García‐Doval

Espinosa-Pereiro

Garate

2020

Actas Dermo-Sifiliográficas

View full text Add to dashboard Cite

The sentinel node biopsy has not come of age

Abstract: Linked Article: McGregor et al. Br J Dermatol 2019; 181:423.

Cited by 4 publications

References 4 publications

Improved methodology in determining melanoma mortality and selecting patients for immunotherapy

Improved methodology in determining melanoma mortality and selecting patients for immunotherapy

Knowledge and attitudes of Australian dermatologists towards sentinel lymph node biopsy for melanoma: a mixed methods study

Biopsia selectiva del ganglio centinela en melanoma: ni utilidad terapéutica, ni es buena para seleccionar los pacientes que podrían beneficiarse de la inmunoterapia adyuvante

Contact Info

Product

Resources

About