前哨淋巴结活检对肢端黑色素瘤患者预后的影响。

Influence of sentinel lymph node biopsy on the prognosis of acral melanoma patients.

作者信息

Francischetto Thiago, Falcão Ana Clara, Neves Adson Santos, Lira Ana Beatriz, Moura Robson Freitas de, Moura Thiago Souza Oliveira Freitas de, Santos Juvandy Antonio Inacio, Lima André Bacellar Costa, Lessa Marco Antonio Oliveira, Santos Jussamara Britos, Albuquerque Alexandre Farias de, Pinheiro Vaner Paulo da Silva Fonseca

机构信息

Liga Bahiana Contra o Câncer, Hospital Aristides Maltez, Salvador, Bahia, Brazil; Faculty of Medicine, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Hospital Santa Izabel, Santa Casa de Misericordia da Bahia, Salvador, Bahia, Brazil.

Faculty of Medicine, Universidade Federal da Bahia, Salvador, Bahia, Brazil.

出版信息

An Bras Dermatol. 2025 Jun 18;100(4):501129. doi: 10.1016/j.abd.2025.501129.

DOI:10.1016/j.abd.2025.501129

PMID:40554356

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12213945/

Abstract

BACKGROUND

Sentinel lymph node (SLN) biopsy in melanoma patients has an important role in staging, prognosis assessment, and treatment definition. Few studies have evaluated its role in the Acral Melanoma (AM) subtype.

OBJECTIVE

To evaluate the results of SLN biopsy in 79 patients with acral melanoma treated at a single oncological center and compare them with the data described in the literature.

METHODS

Between January 2016 and December 2022, the authors analyzed all patients with AM who underwent SLN biopsy in a single institute. The authors analyzed the epidemiological, clinical and histopathological data. Overall Survival (OS) and Disease-Free Survival (DFS) curves were estimated using the Kaplan-Meier method. Multivariate analyses were conducted using the Cox regression model.

RESULTS

During the period, the authors analyzed 79 cases. The mean age was 60 years and median thickness was 4.5 mm and 67.1% had ulceration. SLN was positive in 27 patients (34.2%). The estimated OS and DFS were 67.7% and 45.2%. OS was better in the negative SLN group compared to the positive SLN group (70.9% vs. 53.2%), but without statistical significance (p = 0.08). Estimated DFS for positive SLN was associated with a significantly worse prognosis (33.8 × 46.7%, p = 0.001).

STUDY LIMITATIONS

The retrospective nature of the study and the limited number of patients.

CONCLUSIONS

The present study has significant implications for determining prognosis. Patients with AM and positive SLN had a worst prognosis compared to those with negative SLN.

摘要

背景

前哨淋巴结（SLN）活检在黑色素瘤患者的分期、预后评估及治疗方案确定中具有重要作用。很少有研究评估其在肢端黑色素瘤（AM）亚型中的作用。

目的

评估在单一肿瘤中心接受治疗的79例肢端黑色素瘤患者前哨淋巴结活检的结果，并与文献报道的数据进行比较。

方法

2016年1月至2022年12月期间，作者分析了在单一机构接受前哨淋巴结活检的所有AM患者。作者分析了流行病学、临床和组织病理学数据。采用Kaplan-Meier法估计总生存期（OS）和无病生存期（DFS）曲线。使用Cox回归模型进行多变量分析。

结果

在此期间，作者分析了79例病例。平均年龄为60岁，中位厚度为4.5毫米，67.1%有溃疡形成。27例患者（34.2%）前哨淋巴结呈阳性。估计的OS和DFS分别为67.7%和45.2%。前哨淋巴结阴性组的OS优于阳性组（70.9%对53.2%），但无统计学意义（p = 0.08）。前哨淋巴结阳性患者的估计DFS与预后明显较差相关（33.8×46.7%，p = 0.001）。