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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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| Published in: | Journal of clinical medicine 2024-09, Vol.13 (17), p.5238 |
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| container_issue | 17 |
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| container_title | Journal of clinical medicine |
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| creator | 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 |
| description | 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. |
| doi_str_mv | 10.3390/jcm13175238 |
| format | article |
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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.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm13175238</identifier><identifier>PMID: 39274453</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Biopsy ; Clinical trials ; Immunotherapy ; Lymphatic system ; Medical prognosis ; Melanoma ; Metastasis ; Patients ; Survival analysis ; Tumors</subject><ispartof>Journal of clinical medicine, 2024-09, Vol.13 (17), p.5238</ispartof><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c242t-d410947601a6a087d197aae87cace5804c9cf29d48feb84b97eaf6b907dd8f163</cites><orcidid>0009-0003-2310-0346 ; 0000-0002-8443-7458 ; 0000-0002-0098-1406 ; 0000-0001-7126-5506 ; 0000-0002-0097-2139</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3104036167/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3104036167?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,25753,27924,27925,37012,37013,44590,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39274453$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roccuzzo, Gabriele</creatorcontrib><creatorcontrib>Macagno, Nicole</creatorcontrib><creatorcontrib>Grignani, Pietro</creatorcontrib><creatorcontrib>Astrua, Chiara</creatorcontrib><creatorcontrib>Brizio, Matteo Giovanni</creatorcontrib><creatorcontrib>Cavaliere, Giovanni</creatorcontrib><creatorcontrib>Picciotto, Franco</creatorcontrib><creatorcontrib>Caliendo, Virginia</creatorcontrib><creatorcontrib>Fruttero, Enrico</creatorcontrib><creatorcontrib>Ribero, Simone</creatorcontrib><creatorcontrib>Fava, Paolo</creatorcontrib><creatorcontrib>Quaglino, Pietro</creatorcontrib><title>Treatment Patterns and Outcomes of Stage III Melanoma Patients with Positive Sentinel Lymph Node Biopsy: A Real-Life Experience</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>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.</description><subject>Biopsy</subject><subject>Clinical trials</subject><subject>Immunotherapy</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Melanoma</subject><subject>Metastasis</subject><subject>Patients</subject><subject>Survival analysis</subject><subject>Tumors</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpd0c1PHCEYBnDS1FSjnrw3JF6amFEYmAG8qbG6yaobdz1PWOadymZmGIGx3VP_dfGjzUYuEPLjyUsehA4oOWZMkZOV6SijosiZ_IJ2ciJERphkXzfO22g_hBVJS0qeU_ENbTOVC84LtoP-Ljzo2EEf8UzHCL4PWPc1vhujcR0E7Bo8j_oX4Mlkgm-g1b3r9Ku16U3Av218xDMXbLTPgOfpzvbQ4um6Gx7xrasBn1s3hPUpPsP3oNtsahvAl38G8CnAwB7aanQbYP9j30UPPy8XF9fZ9O5qcnE2zUzO85jVnBLFRUmoLjWRoqZKaA1SGG2gkIQbZZpc1Vw2sJR8qQToplwqIupaNrRku-jHe-7g3dMIIVadDQba9B9wY6gYJbzglKsi0cNPdOVG36fp3hRhJS1FUkfvyngXgoemGrzttF9XlFSv1VQb1ST9_SNzXHZQ_7f_imAvvMqI1g</recordid><startdate>20240904</startdate><enddate>20240904</enddate><creator>Roccuzzo, Gabriele</creator><creator>Macagno, Nicole</creator><creator>Grignani, Pietro</creator><creator>Astrua, Chiara</creator><creator>Brizio, Matteo Giovanni</creator><creator>Cavaliere, Giovanni</creator><creator>Picciotto, Franco</creator><creator>Caliendo, Virginia</creator><creator>Fruttero, Enrico</creator><creator>Ribero, Simone</creator><creator>Fava, Paolo</creator><creator>Quaglino, Pietro</creator><general>MDPI AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0003-2310-0346</orcidid><orcidid>https://orcid.org/0000-0002-8443-7458</orcidid><orcidid>https://orcid.org/0000-0002-0098-1406</orcidid><orcidid>https://orcid.org/0000-0001-7126-5506</orcidid><orcidid>https://orcid.org/0000-0002-0097-2139</orcidid></search><sort><creationdate>20240904</creationdate><title>Treatment Patterns and Outcomes of Stage III Melanoma Patients with Positive Sentinel Lymph Node Biopsy: A Real-Life Experience</title><author>Roccuzzo, Gabriele ; 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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.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>39274453</pmid><doi>10.3390/jcm13175238</doi><orcidid>https://orcid.org/0009-0003-2310-0346</orcidid><orcidid>https://orcid.org/0000-0002-8443-7458</orcidid><orcidid>https://orcid.org/0000-0002-0098-1406</orcidid><orcidid>https://orcid.org/0000-0001-7126-5506</orcidid><orcidid>https://orcid.org/0000-0002-0097-2139</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biopsy Clinical trials Immunotherapy Lymphatic system Medical prognosis Melanoma Metastasis Patients Survival analysis Tumors |
| title | Treatment Patterns and Outcomes of Stage III Melanoma Patients with Positive Sentinel Lymph Node Biopsy: A Real-Life Experience |
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