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. 2022 Jun 3;22(1):610.
doi: 10.1186/s12885-022-09705-y.

The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)

Saveria Tropea  1   2 , Paolo Del Fiore  3 , Andrea Maurichi  4 , Roberto Patuzzo  4 , Mario Santinami  4 , Simone Ribero  5   6 , Pietro Quaglino  6 , Virginia Caliendo  7 , Lorenzo Borgognoni  8 , Serena Sestini  8 , Giuseppe Giudice  9 , Eleonora Nacchiero  9 , Corrado Caracò  10 , Adriana Cordova  11 , Nicola Solari  12 , Dario Piazzalunga  13 , Francesca Tauceri  14 , Paolo Carcoforo  15 , Maurizio Lombardo  16 , Sara Cavallari  17 , Simone Mocellin  1   2 ; Italian Melanoma Intergroup (IMI)
Collaborators, Affiliations

The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)

Saveria Tropea et al. BMC Cancer. .

Abstract

Background: The management of melanoma patients with metastatic melanoma in the sentinel nodes (SN) is evolving based on the results of trials questioning the impact of completion lymph node dissection (CLND) and demonstrating the efficacy of new adjuvant treatments. In this landscape, new prognostic tools for fine risk stratification are eagerly sought to optimize the therapeutic path of these patients.

Methods: A retrospective cohort of 2,086 patients treated with CLND after a positive SN biopsy in thirteen Italian Melanoma Centers was reviewed. Overall survival (OS) was the outcome of interest; included independent variables were the following: age, gender, primary melanoma site, Breslow thickness, ulceration, sentinel node tumor burden (SNTB), number of positive SN, non-sentinel lymph nodes (NSN) status. Univariate and multivariate survival analyses were performed using the Cox proportional hazard regression model.

Results: The 3-year, 5-year and 10-year OS rates were 79%, 70% and 54%, respectively. At univariate analysis, all variables, except for primary melanoma body site, were found to be statistically significant prognostic factors. Multivariate Cox regression analysis indicated that older age (P < 0.0001), male gender (P = 0.04), increasing Breslow thickness (P < 0.0001), presence of ulceration (P = 0.004), SNTB size (P < 0.0001) and metastatic NSN (P < 0.0001) were independent negative predictors of OS.

Conclusion: The above results were utilized to build a nomogram in order to ease the practical implementation of our prognostic model, which might improve treatment personalization.

Keywords: CLND; Completion lymph node dissection; Melanoma; Metastatic melanoma in the sentinel nodes; Nomogram; Overall survival; Prognostic factors; Risk stratification; Treatment of cutaneous melanoma; Tumor burden.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
OS Kaplan Meier curve
Fig. 2
Fig. 2
OS according to TB
Fig. 3
Fig. 3
Prognostic nomogram
See this image and copyright information in PMC

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