Background

Sentinel lymph node (SLN) biopsy is widely performed for melanoma with certain histologic parameters and offers important prognostic and staging information. Breslow thickness (BT) by itself also provides meaningful prognostic information.

Objective

To evaluate whether SLN status provides prognostic information independent from that which is already provided by BT.

Methods

We conducted a retrospective cohort study of 896 patients who underwent SLN biopsy for primary cutaneous melanoma. Stratified analysis of the impact of SLN status within BT groups (0.01-1 mm, 1.01-2.00 mm, 2.01-4.00 mm, and >4.00 mm) was performed. In addition, a Cox proportional hazard model was fit to evaluate the interaction between BT unadjusted and then adjusted for SLN status to determine whether predictive ability is improved.

Results

Having a negative SLN did not confer a statistically significant survival advantage for any BT subgroup (P = .54, .075, .17, and .95 for subgroups 0.01-1 mm, 1.01-2.00 mm, 2.01-4.00 mm, and >4.00 mm, respectively). In multivariate analysis, SLN status did not demonstrate independent prognostic ability over that of BT alone (P = .067).

Limitations

Retrospective study, single institution.

Conclusion

Our data suggest that SLN status does not offer better prognostic information for patients than BT alone.

中文翻译：

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根据Breslow厚度进行前哨淋巴结活检对皮肤黑色素瘤的预后价值。

背景

前哨淋巴结（SLN）活检广泛用于具有某些组织学参数的黑色素瘤，并提供重要的预后和分期信息。Breslow厚度（BT）本身也可提供有意义的预后信息。

客观的

评估SLN状态是否提供独立于BT已提供的预后信息的预后信息。

方法

我们对896例因原发性皮肤黑色素瘤行SLN活检的患者进行了回顾性队列研究。对BT组（0.01-1 mm，1.01-2.00 mm，2.01-4.00 mm和> 4.00 mm）内SLN状况的影响进行了分层分析。此外，使用Cox比例风险模型评估未经调整的BT之间的相互作用，然后针对SLN状态进行调整，以确定预测能力是否得到改善。

结果

对于任何BT子组，SLN阴性均不能赋予统计学上显着的生存优势（ 对于0.01-1 mm，1.01-2.00 mm，2.01-4.00 mm子组，P = .54，.075，.17和.95，>分别为4.00毫米）。在多变量分析中，SLN状态没有显示出比单独的BT具有独立的预后能力（P  = .067）。

局限性

回顾性研究，单一机构。

结论

我们的数据表明，与仅使用BT相比，SLN状态不能为患者提供更好的预后信息。