Serviços Personalizados
Journal
Artigo
Indicadores
Citado por SciELO
Links relacionados
Similares em SciELO
Compartilhar
Medicina (Buenos Aires)
versão impressa ISSN 0025-7680versão On-line ISSN 1669-9106
Resumo
QUILDRIAN, Sergio D. et al. Current management of patients with cutaneous melanoma with a positive sentinel lymph node. Medicina (B. Aires) [online]. 2023, vol.83, n.3, pp.376-383. ISSN 0025-7680.
Introduction
: Immediate completion lymph node dissection (CLND) performed in patients with a positive sentinel lymph node biopsy (SLNB) cutaneous melanoma is not associated with improved melanoma specific survival versus active surveillance (AS) using nodal ul trasound. Clinical practice experience and outcomes of AS and adjuvant therapy is now starting to be published in literature.
Methods
: Retrospective analysis of patients with a positive-SLNB between June/2017-February/2022. Impact of management on any-site recurrence free survival (RFS), isolated nodal recurrence (INR), distant metasta sis-free survival (DMFS) and melanoma-specific survival (MSS) was evaluated.
Results
: From 126 SLNB, 31 (24.6%) were positive: 24 received AS and 7 CLND. Twenty-one (68%) received ad juvant therapy (AS, 67% and CLND, 71%). With a median follow-up of 18 months, 10 patients developed recur rent disease with an estimated 2-yr RFS of 73% (CI95%, 0.55-0.86) (30% in AS group vs. 43% in dissection group; P = 0.65). Four died of melanoma with an estimated 2-yr MSS of 82% (CI 95%, 0.63-0.92) and no differences between AS and CLND groups (P = 0.21). Estimated 2-yr DMFS of the whole cohort was 76% (CI 95%, 0.57-0.88) with no differences between groups (P = 0.33).
Conclusion
: Active surveillance strategy has been adopted for most positive-SLNB cutaneous melanoma patients. Adjuvant therapy without immediate CLND was delivered in nearly 70% of patients. Our results align with outcomes of randomized control trials and previous real-world data.
Palavras-chave : Cutaneous melanoma; Positive sentinel lymph node biopsy; Active surveillance; Follow-up stud ies; Immunotherapy.