Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy

Chiao En Wu, Chia Hsun Hsieh, Cheng Jen Chang, Jiun Ting Yeh, Tseng tong Kuo, Chih Hsun Yang, Yung Feng Liao, Kun Ju Lin, Yung Chang Lin, John Wen Cheng Chang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background/purpose: Sentinel lymph node biopsy (SLNB) is a standard procedure in the management of clinically node-negative melanoma. However, few studies have been performed on SLNB in Asia, which is an acral melanoma-prevalent area. This study evaluated the clinicopathologic prognostic factors of disease-free survival (DFS) and overall survival (OS) in Taiwanese patients with cutaneous melanoma who received wide excision and SLNB. The prognosis of patients with false-negative (FN) SLNB was also evaluated. Methods: Malignant melanoma cases were reviewed for 518 patients who were treated between January 2000 and December 2011. Of these patients, 127 patients with node-negative cutaneous melanoma who received successful SLNB were eligible for inclusion in the study. Results: The SLNB-positive rate was 34.6%. The median DFS was 51.5 months, and the median OS was 90.9 months at the median follow-up of 36.6 months. Multivariate analysis revealed that patients whose melanoma had a Breslow thickness greater than 2mm had a significantly shorter DFS than patients whose melanoma had a Breslow thickness of 2mm or less [hazard ratio (HR), 3.421; p=0.005]. Independent prognostic factors of OS were a Breslow thickness greater than 2mm (HR, 4.435; p=0.002); nonacral melanoma (HR, 3.048; p=0.001); and an age older than 65 years (HR, 2.819; p=0.036). During the follow-up period, 13 of 83 SLN-negative patients developed a regional nodal recurrence. The SLNB failure rate was 15.7% and the FN rate was 22.8%. Compared to patients with a true-positive SLNB, patients with FN SLNB had a significantly shorter DFS (. p=0.001) but no significant difference in OS (. p=0.262). Conclusion: Except for the pathologic subtypes, prognostic factors in Taiwan are similar to those used in other melanoma-prevalent countries. Identifying and closely monitoring patients at risk of nodal recurrence after a negative SLNB is important.

Original languageEnglish
Pages (from-to)415-421
Number of pages7
JournalJournal of the Formosan Medical Association
Volume114
Issue number5
DOIs
Publication statusPublished - May 1 2015
Externally publishedYes

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Sentinel Lymph Node Biopsy
Melanoma
Skin
Disease-Free Survival
Survival
Recurrence
Physiologic Monitoring
Taiwan
Multivariate Analysis
Extremities

Keywords

  • Acral lentiginous melanoma
  • Cutaneous melanoma
  • Malignant melanoma
  • Prognostic factors
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy. / Wu, Chiao En; Hsieh, Chia Hsun; Chang, Cheng Jen; Yeh, Jiun Ting; Kuo, Tseng tong; Yang, Chih Hsun; Liao, Yung Feng; Lin, Kun Ju; Lin, Yung Chang; Chang, John Wen Cheng.

In: Journal of the Formosan Medical Association, Vol. 114, No. 5, 01.05.2015, p. 415-421.

Research output: Contribution to journalArticle

Wu, Chiao En ; Hsieh, Chia Hsun ; Chang, Cheng Jen ; Yeh, Jiun Ting ; Kuo, Tseng tong ; Yang, Chih Hsun ; Liao, Yung Feng ; Lin, Kun Ju ; Lin, Yung Chang ; Chang, John Wen Cheng. / Prognostic factors for Taiwanese patients with cutaneous melanoma undergoing sentinel lymph node biopsy. In: Journal of the Formosan Medical Association. 2015 ; Vol. 114, No. 5. pp. 415-421.
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abstract = "Background/purpose: Sentinel lymph node biopsy (SLNB) is a standard procedure in the management of clinically node-negative melanoma. However, few studies have been performed on SLNB in Asia, which is an acral melanoma-prevalent area. This study evaluated the clinicopathologic prognostic factors of disease-free survival (DFS) and overall survival (OS) in Taiwanese patients with cutaneous melanoma who received wide excision and SLNB. The prognosis of patients with false-negative (FN) SLNB was also evaluated. Methods: Malignant melanoma cases were reviewed for 518 patients who were treated between January 2000 and December 2011. Of these patients, 127 patients with node-negative cutaneous melanoma who received successful SLNB were eligible for inclusion in the study. Results: The SLNB-positive rate was 34.6{\%}. The median DFS was 51.5 months, and the median OS was 90.9 months at the median follow-up of 36.6 months. Multivariate analysis revealed that patients whose melanoma had a Breslow thickness greater than 2mm had a significantly shorter DFS than patients whose melanoma had a Breslow thickness of 2mm or less [hazard ratio (HR), 3.421; p=0.005]. Independent prognostic factors of OS were a Breslow thickness greater than 2mm (HR, 4.435; p=0.002); nonacral melanoma (HR, 3.048; p=0.001); and an age older than 65 years (HR, 2.819; p=0.036). During the follow-up period, 13 of 83 SLN-negative patients developed a regional nodal recurrence. The SLNB failure rate was 15.7{\%} and the FN rate was 22.8{\%}. Compared to patients with a true-positive SLNB, patients with FN SLNB had a significantly shorter DFS (. p=0.001) but no significant difference in OS (. p=0.262). Conclusion: Except for the pathologic subtypes, prognostic factors in Taiwan are similar to those used in other melanoma-prevalent countries. Identifying and closely monitoring patients at risk of nodal recurrence after a negative SLNB is important.",
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author = "Wu, {Chiao En} and Hsieh, {Chia Hsun} and Chang, {Cheng Jen} and Yeh, {Jiun Ting} and Kuo, {Tseng tong} and Yang, {Chih Hsun} and Liao, {Yung Feng} and Lin, {Kun Ju} and Lin, {Yung Chang} and Chang, {John Wen Cheng}",
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AU - Hsieh, Chia Hsun

AU - Chang, Cheng Jen

AU - Yeh, Jiun Ting

AU - Kuo, Tseng tong

AU - Yang, Chih Hsun

AU - Liao, Yung Feng

AU - Lin, Kun Ju

AU - Lin, Yung Chang

AU - Chang, John Wen Cheng

PY - 2015/5/1

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N2 - Background/purpose: Sentinel lymph node biopsy (SLNB) is a standard procedure in the management of clinically node-negative melanoma. However, few studies have been performed on SLNB in Asia, which is an acral melanoma-prevalent area. This study evaluated the clinicopathologic prognostic factors of disease-free survival (DFS) and overall survival (OS) in Taiwanese patients with cutaneous melanoma who received wide excision and SLNB. The prognosis of patients with false-negative (FN) SLNB was also evaluated. Methods: Malignant melanoma cases were reviewed for 518 patients who were treated between January 2000 and December 2011. Of these patients, 127 patients with node-negative cutaneous melanoma who received successful SLNB were eligible for inclusion in the study. Results: The SLNB-positive rate was 34.6%. The median DFS was 51.5 months, and the median OS was 90.9 months at the median follow-up of 36.6 months. Multivariate analysis revealed that patients whose melanoma had a Breslow thickness greater than 2mm had a significantly shorter DFS than patients whose melanoma had a Breslow thickness of 2mm or less [hazard ratio (HR), 3.421; p=0.005]. Independent prognostic factors of OS were a Breslow thickness greater than 2mm (HR, 4.435; p=0.002); nonacral melanoma (HR, 3.048; p=0.001); and an age older than 65 years (HR, 2.819; p=0.036). During the follow-up period, 13 of 83 SLN-negative patients developed a regional nodal recurrence. The SLNB failure rate was 15.7% and the FN rate was 22.8%. Compared to patients with a true-positive SLNB, patients with FN SLNB had a significantly shorter DFS (. p=0.001) but no significant difference in OS (. p=0.262). Conclusion: Except for the pathologic subtypes, prognostic factors in Taiwan are similar to those used in other melanoma-prevalent countries. Identifying and closely monitoring patients at risk of nodal recurrence after a negative SLNB is important.

AB - Background/purpose: Sentinel lymph node biopsy (SLNB) is a standard procedure in the management of clinically node-negative melanoma. However, few studies have been performed on SLNB in Asia, which is an acral melanoma-prevalent area. This study evaluated the clinicopathologic prognostic factors of disease-free survival (DFS) and overall survival (OS) in Taiwanese patients with cutaneous melanoma who received wide excision and SLNB. The prognosis of patients with false-negative (FN) SLNB was also evaluated. Methods: Malignant melanoma cases were reviewed for 518 patients who were treated between January 2000 and December 2011. Of these patients, 127 patients with node-negative cutaneous melanoma who received successful SLNB were eligible for inclusion in the study. Results: The SLNB-positive rate was 34.6%. The median DFS was 51.5 months, and the median OS was 90.9 months at the median follow-up of 36.6 months. Multivariate analysis revealed that patients whose melanoma had a Breslow thickness greater than 2mm had a significantly shorter DFS than patients whose melanoma had a Breslow thickness of 2mm or less [hazard ratio (HR), 3.421; p=0.005]. Independent prognostic factors of OS were a Breslow thickness greater than 2mm (HR, 4.435; p=0.002); nonacral melanoma (HR, 3.048; p=0.001); and an age older than 65 years (HR, 2.819; p=0.036). During the follow-up period, 13 of 83 SLN-negative patients developed a regional nodal recurrence. The SLNB failure rate was 15.7% and the FN rate was 22.8%. Compared to patients with a true-positive SLNB, patients with FN SLNB had a significantly shorter DFS (. p=0.001) but no significant difference in OS (. p=0.262). Conclusion: Except for the pathologic subtypes, prognostic factors in Taiwan are similar to those used in other melanoma-prevalent countries. Identifying and closely monitoring patients at risk of nodal recurrence after a negative SLNB is important.

KW - Acral lentiginous melanoma

KW - Cutaneous melanoma

KW - Malignant melanoma

KW - Prognostic factors

KW - Sentinel lymph node biopsy

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