肢端黑色素瘤患者前哨淋巴结活检：巴西国家癌症研究所 201 例分析。

Sentinel Lymph Node Biopsy in Patients With Acral Melanoma: Analysis of 201 Cases From the Brazilian National Cancer Institute.

机构信息

Brazilian National Cancer Institute, Corrective Bone Tissue Section, Rio de Janeiro, Brazil.

Department of Epidemiology and Quantitative Methods in Health, Oswaldo Cruz Foundation, National School of Public Health, Rio de Janeiro, Brazil.

出版信息

Dermatol Surg. 2019 Aug;45(8):1026-1034. doi: 10.1097/DSS.0000000000001785.

DOI:10.1097/DSS.0000000000001785

PMID:30908362

Abstract

BACKGROUND

Sentinel lymph node biopsy (SLNB) is the most powerful predictor of relapse-free survival (RFS) and overall survival (OS). No studies have evaluated survival of acral melanoma (AM) undergoing SLNB in Brazil.

OBJECTIVE

The objective of this study was to investigate the factors associated with the survival of patients with AM undergoing SLNB.

MATERIALS AND METHODS

Patients diagnosed with AM and submitted to SLNB were included in this study. We evaluated the epidemiologic, clinical, and histopathological data. Overall survival and RFS curves were estimated using the Kaplan-Meier method. Multivariable analyses were conducted using the Cox regression model.

RESULTS

Among the 201 patients, 117 (58.2%) were female. The median age was 64 years old. Median tumor depth was 5.0 mm. Lesions were ulcerated in 134 (66.7%). Five-year OS and RFS rates were 44.6% and 38.6%, respectively. Median follow-up time was 39 months. The factors associated with OS were Breslow thickness, ulceration, and SLNB status, and for RFS, they were Breslow thickness and SLNB status.

CONCLUSION

This is the largest series of AM submitted to SLNB. The 5-year OS and RFS rates were low (44.6% and 38.6%, respectively), and the main prognostic factors for OS were Breslow thickness, ulceration, and the status of SLNB.

摘要

背景

前哨淋巴结活检（SLNB）是无复发生存率（RFS）和总生存率（OS）的最有力预测因素。尚未有研究评估在巴西进行 SLNB 的肢端黑色素瘤（AM）患者的生存情况。

目的

本研究旨在调查与接受 SLNB 的 AM 患者生存相关的因素。

材料和方法

本研究纳入了诊断为 AM 并接受 SLNB 的患者。我们评估了流行病学、临床和组织病理学数据。使用 Kaplan-Meier 方法估计总生存率和 RFS 曲线。使用 Cox 回归模型进行多变量分析。

结果

在 201 例患者中，117 例（58.2%）为女性。中位年龄为 64 岁。中位肿瘤深度为 5.0mm。134 例（66.7%）病变为溃疡。5 年 OS 和 RFS 率分别为 44.6%和 38.6%。中位随访时间为 39 个月。与 OS 相关的因素是 Breslow 厚度、溃疡和 SLNB 状态，而与 RFS 相关的因素是 Breslow 厚度和 SLNB 状态。