Tejera-Vaquerizo Antonio, Boada Aram, Ribero Simone, Puig Susana, Paradela Sabela, Moreno-Ramírez David, Cañueto Javier, de Unamuno-Bustos Blanca, Brinca Ana, Descalzo-Gallego Miguel A, Osella-Abate Simona, Cassoni Paola, Podlipnik Sebastian, Carrera Cristina, Vidal-Sicart Sergi, Pigem Ramón, Toll Agustí, Rull Ramón, Alos Llucìa, Requena Celia, Bolumar Isidro, Traves Víctor, Pla Ángel, Fernández-Orland Almudena, Jaka Ane, Fernández-Figueras María Teresa, Richarz Nina Anika, Vieira Ricardo, Botella-Estrada Rafael, Román-Curto Concepción, Ferrándiz-Pulido Lara, Iglesias-Pena Nicolás, Ferrándiz Carlos, Malvehy Josep, Quaglino Pietro, Nagore Eduardo
Dermatology Department, Instituto Dermatológico GlobalDerm, 14700 Palma del Río, Spain.
Cutaneous Oncology Unit, Hospital San Juan de Dios, 14012 Córdoba, Spain.
J Clin Med. 2021 Dec 15;10(24):5878. doi: 10.3390/jcm10245878.
The therapeutic value of sentinel lymph node biopsy (SLNB) in thin melanoma remains controversial. The aim of this study is to determine the role of SLNB in the survival of thin melanomas (≤1 mm). A multicenter retrospective observational study was designed. A propensity score matching was performed to compare patients who underwent SLNB vs. observation. A multivariate Cox regression was used. A total of 1438 patients were matched by propensity score. There were no significant differences in melanoma-specific survival (MSS) between the SLNB and observation groups. Predictors of MSS in the multivariate model were age, tumor thickness, ulceration, and interferon treatment. Results were similar for disease-free survival and overall survival. The 5- and 10-year MSS rates for SLN-negative and -positive patients were 98.5% vs. 77.3% ( < 0.001) and 97.3% vs. 68.7% ( < 0.001), respectively. SLNB does not improve MSS in patients with thin melanoma. It also had no impact on DSF or OS. However, a considerable difference in MSS, DFS, and OS between SLN-positive and -negative patients exists, confirming its value as a prognostic procedure and therefore we recommend discussing the option of SLNB with patients.
前哨淋巴结活检（SLNB）在薄型黑色素瘤中的治疗价值仍存在争议。本研究的目的是确定SLNB在薄型黑色素瘤（≤1mm）生存中的作用。设计了一项多中心回顾性观察研究。进行倾向评分匹配以比较接受SLNB与接受观察的患者。使用多变量Cox回归分析。共有1438例患者通过倾向评分进行匹配。SLNB组和观察组之间的黑色素瘤特异性生存率（MSS）没有显著差异。多变量模型中MSS的预测因素为年龄、肿瘤厚度、溃疡和干扰素治疗。无病生存率和总生存率的结果相似。SLN阴性和阳性患者的5年和10年MSS率分别为98.5%对77.3%（<0.001）和97.3%对68.7%（<0.001）。SLNB并不能改善薄型黑色素瘤患者的MSS。它对无病生存率（DFS）或总生存率（OS）也没有影响。然而，SLN阳性和阴性患者之间在MSS、DFS和OS方面存在相当大的差异，证实了其作为一种预后评估方法的价值，因此我们建议与患者讨论SLNB的选择。
