Leong Stanley P L, Accortt Neil A, Essner Richard, Ross Merrick, Gershenwald Jeffrey E, Pockaj Barbara, Hoekstra Harald J, Garberoglio Carlos, White Richard L, Chu David, Biel Merrill, Charney Kim, Wanebo Harold, Avisar Eli, Vetto John, Soong Seng-Jaw
Department of Surgery, University of California, San Francisco, CA 94115, USA.
Arch Otolaryngol Head Neck Surg. 2006 Apr;132(4):370-3. doi: 10.1001/archotol.132.4.370.
To determine the impact of sentinel lymph node (SLN) status and other risk factors on recurrence and overall survival in head and neck melanoma patients.
The SLN Working Group, based in San Francisco, Calif, with its 11 member centers, the John Wayne Cancer Institute, and The University of Texas M. D. Anderson Cancer Center pooled data on 629 primary head and neck melanoma patients who had selective sentinel lymphadenectomy. A total of 614 subjects were analyzable. All centers obtained internal review board approval and adhered to the Health Insurance Portability and Accountability Act of 1996 regulations. A Cox proportional hazards model was used to identify factors associated with overall and disease-free survival.
Tertiary care medical centers.
Clinical outcome of head and neck melanoma patients undergoing selective sentinel lymphadenectomy.
Overall, 10.1% (n = 62) of the subjects had at least 1 positive node. Subjects with positive SLN status had significantly thicker tumors (mean thickness, 2.8 vs 2.1 mm; P < .001), and were more likely to have ulcerated tumors (P = .004). During the median follow-up of 3.3 years, the overall mortality from head and neck melanoma was 10%, with more than 20% experiencing at least 1 recurrence. Multivariate analysis showed that tumor site was an independent predictor of mortality; location on the scalp had a more than 3-fold (P < .001) greater mortality than tumors on the face. Tumor thickness was also an independent predictor of overall survival, and SLN status was the most important predictor of disease-free survival in the multivariate model (P < .001). Tumors on the scalp had the highest rate of recurrence, while those on the neck had the lowest. Tumor ulceration was the significant predictor of time to recurrence or disease-free survival (P < .001).
In this multicenter study, SLN status and other risk factors have an effect on recurrence and/or overall survival.
确定前哨淋巴结（SLN）状态及其他危险因素对头颈部黑色素瘤患者复发和总生存期的影响。
位于加利福尼亚州旧金山的SLN工作组及其11个成员中心、约翰·韦恩癌症研究所和德克萨斯大学MD安德森癌症中心汇总了629例行选择性前哨淋巴结清扫术的原发性头颈部黑色素瘤患者的数据。共有614名受试者可进行分析。所有中心均获得了内部审查委员会的批准，并遵守了1996年《健康保险流通与责任法案》的规定。采用Cox比例风险模型来确定与总生存期和无病生存期相关的因素。
三级医疗中心。
接受选择性前哨淋巴结清扫术的头颈部黑色素瘤患者的临床结局。
总体而言，10.1%（n = 62）的受试者至少有1个阳性淋巴结。SLN状态为阳性的受试者肿瘤明显更厚（平均厚度，2.8 vs 2.1 mm；P < .001），且更有可能出现溃疡型肿瘤（P = .004）。在3.3年的中位随访期内，头颈部黑色素瘤的总死亡率为10%，超过20%的患者经历了至少1次复发。多变量分析显示，肿瘤部位是死亡率的独立预测因素；头皮部位的肿瘤死亡率比面部肿瘤高3倍以上（P < .001）。肿瘤厚度也是总生存期的独立预测因素，在多变量模型中，SLN状态是无病生存期的最重要预测因素（P < .001）。头皮部位的肿瘤复发率最高，而颈部的肿瘤复发率最低。肿瘤溃疡是复发时间或无病生存期的重要预测因素（P < .001）。
在这项多中心研究中，SLN状态及其他危险因素对复发和/或总生存期有影响。
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