Survival of sentinel node biopsy versus observation in intermediate-thickness melanoma: A Dutch population-based study

R.M.H. Roumen*, M.S. Schuurman, M.J. Aarts, A.J.G. Maaskant-Braat, G. Vreugdenhil, W.J. Louwman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background The Multicenter Selective Lymphadenectomy Trial (MSLT-1) comparing survival after a sentinel lymph node biopsy (SLNB) versus nodal observation in melanoma patients did not show a significant benefit favoring SLNB. However, in subgroup analyses melanoma-specific survival among patients with nodal metastases seemed better.Aim To evaluate the association of performing a SLNB with overall survival in intermediate thickness melanoma patients in a Dutch population-based daily clinical setting.Methods Survival, excess mortality adjusted for age, gender, Breslow-thickness, ulceration, histological subtype, location, co-morbidity and socioeconomic status were calculated in a population of 1,989 patients diagnosed with malignant cutaneous melanoma (1.2-3.5 mm) on the trunk or limb between 2000-2016 in ten hospitals in the South East area, The Netherlands.Results A SLNB was performed in 51% of the patients (n = 1008). Ten-year overall survival after SLNB was 75% (95%CI, 71%-78%) compared to 61% (95%CI 57%-64%) following observation. After adjustment for risk factors, a lower risk on death (HR = 0.80, 95%CI 0.66-0.96) was found after SLNB compared to observation only.Conclusions SLNB in patients with intermediate-thickness melanoma on trunk or limb resulted in a 14% absolute and significant 10-year survival difference compared to those without SLNB.
Original languageEnglish
Article numbere0252021
Number of pages13
JournalPLOS ONE
Volume16
Issue number5
DOIs
Publication statusPublished - 25 May 2021

Keywords

  • CUTANEOUS MELANOMA
  • PROGNOSTIC-SIGNIFICANCE
  • STAGE-I
  • DISSECTION
  • MANAGEMENT
  • ASSOCIATION
  • MULTICENTER
  • METASTASIS

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