Treatment Patterns and Outcomes of Stage III Melanoma Patients with Positive Sentinel Lymph Node Biopsy: A Real-Life Experience

Advancements in managing stage III melanoma have involved the implementation of adjuvant therapies alongside a simultaneous decrease in the utilization of completion lymph node dissection (CLND) following positive sentinel node biopsy (SLNB). This retrospective study from the University of Turin...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-09, Vol.13 (17), p.5238
Main Authors: Roccuzzo, Gabriele, Macagno, Nicole, Grignani, Pietro, Astrua, Chiara, Brizio, Matteo Giovanni, Cavaliere, Giovanni, Picciotto, Franco, Caliendo, Virginia, Fruttero, Enrico, Ribero, Simone, Fava, Paolo, Quaglino, Pietro
Format: Article
Language:English
Subjects:
Biopsy
Clinical trials
Immunotherapy
Lymphatic system
Medical prognosis
Melanoma
Metastasis
Patients
Survival analysis
Tumors
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Summary:Advancements in managing stage III melanoma have involved the implementation of adjuvant therapies alongside a simultaneous decrease in the utilization of completion lymph node dissection (CLND) following positive sentinel node biopsy (SLNB). This retrospective study from the University of Turin's Dermatology Clinic analyzed relapse-free survival (RFS) and overall survival (OS) among stage III melanoma patients (n = 157) who underwent CLND after positive SLNB versus those who did not receive such procedure. Patients without CLND had a median RFS of 49 months (95% CI 42-NA), while CLND recipients showed 51 months (95% CI 31-NA) ( = 0.139). The 48-month OS for non-CLND patients was 79.8% (95% CI 58.2-91.0) versus 79.2% (95% CI 67.5-87.0) for CLND recipients ( = 0.463). Adjusted Hazard Ratios through inverse probability treatment weighting revealed the impact of CLND to be insignificant on RFS (aHR 0.90, 95% CI 0.37-2.22) and marginal on OS (aHR 0.41, 95% CI 0.13-1.21). Conversely, adjuvant therapy significantly reduced the risk of relapse (aHR 0.46, 95% CI 0.25-0.84), irrespective of CLND. : This study corroborates the growing evidence that CLND after positive SLNB does not enhance RFS or OS, while emphasizing the crucial role of adjuvant therapy, be it immunotherapy or targeted therapy, in reducing the risk of relapse in melanoma patients with positive SLNB.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13175238