Background

Melanoma patients with negative nodes after sentinel lymph node biopsy are a heterogeneous group. Current guidelines fail to adequately stratify surveillance and treatment for this group. Also, there is scarce data on adjuvant treatments for these patients.

Objective

To create a nomogram including clinical and pathologic characteristics capable of evaluating the risk for recurrence of primary melanoma patients with negative sentinel lymph node biopsies (SLNBs).

Methods

We used a retrospective cohort of patients who underwent SLNB during 2000-2015 at a single institution.

Results

Our cohort comprised 1213 patients. Among these patients, 967 (79.7%) had a negative SLNB, and mean follow-up was 59.67 months. There were 133 recurrences (13.8%); 45 (33.8%) presented with nodal recurrence, and 35 (26.3%) recurred where a SLNB was performed. Breslow thickness, ulceration, and microsatellitosis were found to be predictive of risk for recurrence at 1, 2, 5, and 10 years.

Limitation

Single center analysis.

Conclusion

We created a predictive nomogram for melanoma patients with negative SLNBs. This nomogram is easy to use and identifies high-risk patients who should have more strict surveillance and be considered for adjuvant treatment.

中文翻译：

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前哨淋巴结活检阴性的高危黑色素瘤患者的诺模图

背景

前哨淋巴结活检后淋巴结阴性的黑色素瘤患者属于异类。当前的指南未能对该人群进行充分的监测和治疗分层。另外，对于这些患者的辅助治疗的数据很少。

客观的

创建包括临床和病理学特征的诺模图，以评估前哨淋巴结活检阴性的原发性黑色素瘤患者的复发风险。

方法

我们采用回顾性队列研究方法，对2000至2015年间在单机构接受SLNB的患者进行回顾性研究。

结果

我们的队列包括1213名患者。在这些患者中，有967名（79.7％）的SLNB阴性，平均随访时间为59.67个月。有133例复发（13.8％）；其中有45例（33.8％）表现为淋巴结复发，而进行SLNB的病例中有35例（26.3％）复发。发现细微的厚度，溃疡和微卫星畸变可预测1、2、5和10年时复发的风险。

局限性

单中心分析。

结论

我们为SLNB阴性的黑色素瘤患者创建了预测性列线图。该列线图易于使用，可识别应进行更严格监视并考虑进行辅助治疗的高危患者。