Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.
Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.
J Am Acad Dermatol. 2018 May;78(5):942-948. doi: 10.1016/j.jaad.2018.01.030. Epub 2018 Jan 31.
Sentinel lymph node (SLN) biopsy is widely performed for melanoma with certain histologic parameters and offers important prognostic and staging information. Breslow thickness (BT) by itself also provides meaningful prognostic information.
To evaluate whether SLN status provides prognostic information independent from that which is already provided by BT.
We conducted a retrospective cohort study of 896 patients who underwent SLN biopsy for primary cutaneous melanoma. Stratified analysis of the impact of SLN status within BT groups (0.01-1 mm, 1.01-2.00 mm, 2.01-4.00 mm, and >4.00 mm) was performed. In addition, a Cox proportional hazard model was fit to evaluate the interaction between BT unadjusted and then adjusted for SLN status to determine whether predictive ability is improved.
Having a negative SLN did not confer a statistically significant survival advantage for any BT subgroup (P = .54, .075, .17, and .95 for subgroups 0.01-1 mm, 1.01-2.00 mm, 2.01-4.00 mm, and >4.00 mm, respectively). In multivariate analysis, SLN status did not demonstrate independent prognostic ability over that of BT alone (P = .067).
Retrospective study, single institution.
Our data suggest that SLN status does not offer better prognostic information for patients than BT alone.
前哨淋巴结（SLN）活检已广泛应用于某些组织学参数的黑色素瘤，可提供重要的预后和分期信息。Breslow 厚度（BT）本身也提供有意义的预后信息。
评估 SLN 状态是否提供了独立于 BT 提供的预后信息。
我们对 896 例接受原发性皮肤黑色素瘤 SLN 活检的患者进行了回顾性队列研究。对 BT 分组（0.01-1mm、1.01-2.00mm、2.01-4.00mm 和>4.00mm）内 SLN 状态的影响进行分层分析。此外，拟合 Cox 比例风险模型以评估 BT 未经调整和调整 SLN 状态后的相互作用，以确定预测能力是否得到改善。
对于任何 BT 亚组，具有阴性 SLN 并不具有统计学显著的生存优势（P=0.54、0.075、0.17 和 0.95，分别为 0.01-1mm、1.01-2.00mm、2.01-4.00mm 和>4.00mm 亚组）。多变量分析表明，SLN 状态相对于 BT 单独并不具有独立的预后能力（P=0.067）。
回顾性研究，单机构。
我们的数据表明，SLN 状态并没有比 BT 单独提供更好的预后信息。
