Long-term outcomes and patterns of recurrence in patients with thin melanoma and a negative sentinel lymph node biopsy: a single-center experience.

IF 1.5 4区 医学 Q3 DERMATOLOGY Melanoma Research Pub Date : 2024-12-01 Epub Date: 2024-06-14 DOI:10.1097/CMR.0000000000000986
Maayan Shemer, Michal Shimonovitz, Rozalin Furer, Adam Abu-Abeid, Danit Dayan, Schlomo Schneebaum, Mor Miodovnik, Eran Nizri
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Abstract

The majority of patients diagnosed with melanoma have thin melanomas (≤1 mm). Data on the rate and pattern of recurrence after a negative sentinel lymph node biopsy (SLNB) are sparse. We retrospectively searched our institutional database and retrieved the records of patients with thin melanomas who underwent an SLNB with negative results. We analyzed patterns of recurrence, time to recurrence, and mode of diagnosis. Thirteen of the 198 patients with thin melanomas and negative SLNB results had tumor recurrence (6.5%): two local in transit (15.4%), three regional (21.3%), and eight distant (61.5%). Distant recurrences tended to occur later than local or regional ones [median disease-free survival = 50 months (95% confidence interval: 36.1-63.9) vs. 34 and 15 months (95% confidence interval: 5.4-24.6), P  = 0.005, respectively]. The percentage of patients with tumor thickness ≥0.8 mm was higher among those who sustained recurrence (84.6 vs. 64.9% for no recurrence, P  = 0.04). The majority of patients with recurrence were not being followed up when diagnosed (69%), and they are presented because of clinical symptoms. Patients with recurrence had lower survival compared with those without recurrence (median: 118 months vs. ongoing survival, P  < 0.001, respectively). Melanoma recurrence in patients with thin melanomas and negative SLNBs is rare, tends to be distant, and negatively affects prognosis. Recurrence tends to occur in patients with melanoma thickness ≥0.8 mm. Further studies are needed to identify patients with high recurrence risk and determine optimal follow-up protocols.

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薄型黑色素瘤前哨淋巴结活检阴性患者的长期疗效和复发模式:单中心经验。
大多数确诊的黑色素瘤患者的黑色素瘤较薄(≤1 毫米)。关于前哨淋巴结活检(SLNB)阴性后的复发率和复发模式的数据很少。我们回顾性地搜索了本机构的数据库,并检索了接受前哨淋巴结活检阴性结果的薄黑色素瘤患者的记录。我们分析了复发模式、复发时间和诊断方式。在198名SLNB结果为阴性的薄层黑色素瘤患者中,有13名患者(6.5%)出现了肿瘤复发:2名患者为局部中转复发(15.4%),3名患者为区域性复发(21.3%),8名患者为远处复发(61.5%)。远处复发往往晚于局部或区域性复发[中位无病生存期 = 50 个月(95% 置信区间:36.1-63.9) vs. 34 和 15 个月(95% 置信区间:5.4-24.6),P = 0.005]。复发患者中肿瘤厚度≥0.8毫米的比例更高(84.6%对64.9%,P = 0.04)。大多数复发患者在确诊时未接受随访(69%),他们因临床症状而就诊。与未复发的患者相比,复发患者的存活率较低(中位数:118 个月与持续存活时间相比,P = 0.05):118个月与持续生存期相比,P
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来源期刊
Melanoma Research
Melanoma Research 医学-皮肤病学
CiteScore
3.40
自引率
4.50%
发文量
139
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Melanoma Research is a well established international forum for the dissemination of new findings relating to melanoma. The aim of the Journal is to promote the level of informational exchange between those engaged in the field. Melanoma Research aims to encourage an informed and balanced view of experimental and clinical research and extend and stimulate communication and exchange of knowledge between investigators with differing areas of expertise. This will foster the development of translational research. The reporting of new clinical results and the effect and toxicity of new therapeutic agents and immunotherapy will be given emphasis by rapid publication of Short Communications. ​Thus, Melanoma Research seeks to present a coherent and up-to-date account of all aspects of investigations pertinent to melanoma. Consequently the scope of the Journal is broad, embracing the entire range of studies from fundamental and applied research in such subject areas as genetics, molecular biology, biochemistry, cell biology, photobiology, pathology, immunology, and advances in clinical oncology influencing the prevention, diagnosis and treatment of melanoma.
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