Dermatology Department, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Instituto Nacional del Cáncer, Santiago, Chile.
Dermatology Department, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
J Am Acad Dermatol. 2021 Jul;85(1):128-134. doi: 10.1016/j.jaad.2021.01.020. Epub 2021 Jan 16.
Obtaining a sentinel lymph node biopsy (SLNB) specimen is a standard staging procedure in the management of cutaneous melanoma. However, there is no consensus on the safe time interval between the primary melanoma biopsy procedure and the SLNB procedure.
We evaluated the association between time from biopsy to SLNB and patients' outcomes for melanoma.
We performed this systematic review and meta-analysis based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Six retrospective studies were included. Nine thousand seven hundred five patients were identified, of which 4383 underwent a SNLB procedure at a time interval defined as early and 4574 at an interval defined as late. A combined hazard ratio of 1.25 (95% confidence interval [CI] 0.92-1.68) was determined, and there was high heterogeneity (I = 83%; P = .002) of the SLNB time interval on melanoma-specific survival. The combined HR for disease-free survival was 1.05 (95% CI 0.95-1.15), with low heterogeneity (I = 9%; P = .36). Regarding overall survival, a combined HR of 1.25 (95% CI 0.92-1.70) was found, with low heterogeneity (I = 37%; P = .2).
There is heterogeneity between some studies.
There are no significant differences in patient outcome between a short interval versus a long interval between the primary biopsy procedure and obtaining a SNLB specimen.
前哨淋巴结活检（SLNB）标本的获取是皮肤黑色素瘤治疗中标准的分期程序。然而，对于原发性黑色素瘤活检与 SLNB 之间的安全时间间隔，尚未达成共识。
我们评估了活检与 SLNB 之间的时间间隔与黑色素瘤患者结局之间的关联。
我们根据系统评价和荟萃分析的首选报告项目的建议进行了这项系统评价和荟萃分析。
纳入了 6 项回顾性研究。共确定了 9705 名患者，其中 4383 名患者在定义为早期的时间间隔内进行了 SLNB 手术，4574 名患者在定义为晚期的时间间隔内进行了 SLNB 手术。确定了 1.25 的综合危险比（95%置信区间 [CI]，0.92-1.68），并且黑色素瘤特异性生存的 SLNB 时间间隔存在高度异质性（I = 83%；P =.002）。无病生存的合并 HR 为 1.05（95% CI，0.95-1.15），异质性低（I = 9%；P =.36）。关于总生存，发现合并 HR 为 1.25（95% CI，0.92-1.70），异质性低（I = 37%；P =.2）。
一些研究之间存在异质性。
原发性活检与获取 SLNB 标本之间的短间隔与长间隔之间，患者结局没有显著差异。
