Background

The impact of histologic regression on sentinel lymph node biopsy (SLNB) status and on clinical outcome is uncertain.

Objective

To investigate whether and to what extent regression <75% is able to predict SLNB status and clinical outcome of patients with melanoma >1-mm thick.

Methods

The study included patients with diagnoses given at 4 centers of the Italian Melanoma Intergroup. Univariate and multivariate Cox proportional hazard models stratified by center were used to analyze the effect of regression on disease-free interval and melanoma-specific survival.

Results

Out of 1182 patients given primary cutaneous melanoma diagnoses during 1998-2015 with a Breslow thickness >1 mm, 954 (304 with and 650 without regression) were included in the analysis. The proportion of patients with a positive SLNB was lower in patients with regression than without (24.4% vs 31.6%, chi-squared test P = .0368). At multivariate analysis, no association was detected between regression and disease-free interval (hazard ratio 1.11, 95% confidence interval 0.85-1.46; P = .4509) or melanoma-specific survival (hazard ratio 1.05, 95% confidence interval 0.77-1.44; P = .7600).

Limitation

Retrospective analysis.

Conclusion

In our series, regression was not an independent prognostic factor in primary cutaneous melanoma patients with Breslow thickness >1 mm whereas it was associated with a lower incidence of SLNB positivity.

中文翻译：

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退化对原发性皮肤黑素瘤厚度> 1 mm的患者的预后影响

背景

组织学消退对前哨淋巴结活检（SLNB）状态和临床结局的影响尚不确定。

客观的

调查是否<75％的回归是否能够以及在多大程度上可以预测厚度> 1-mm的黑素瘤患者的SLNB状态和临床结果。

方法

该研究纳入了在意大利黑色素瘤小组研究中心的4个中心进行诊断的患者。以中心分层的单变量和多变量Cox比例风险模型用于分析回归对无病间隔和黑色素瘤特异性生存的影响。

结果

在1998年至2015年间诊断为原发性皮肤黑色素瘤的1182例患者中，Breslow厚度> 1 mm，其中954例（304例，有650例，无消退）纳入分析。回归患者中SLNB阳性患者的比例低于未回归患者（24.4％比31.6％，卡方检验P  = .0368）。在多变量分析中，未发现回归与无病间隔（危险比1.11，95％置信区间0.85-1.46；P  = .4509）或黑素瘤特异性生存（危险比1.05，95％置信区间0.77-1.44）之间没有关联。 ；P  = .7600）。

局限性

回顾性分析。

结论

在我们的系列研究中，对于Breslow厚度> 1 mm的原发性皮肤黑色素瘤患者，回归并不是独立的预后因素，而SLNB阳性的发生率较低。