TAKE-HOME MESSAGE
In questo studio i ricercatori hanno valutato nei pazienti con Melanoma di spessore maggiore di 1 mm e regressione istologiocamente documentata minore del 75% se quest’ultima può essere un fattore predittivo di linfonodo sentinella positivo.
Lo studio, realizzato da colleghi italiani, è stato condotto su un campione di 1182 pazienti con diagnosi di Melanoma, formulata tra il 1998 e il 2015.
I risultati pubblicati deporrebbero che la regressione <75% documentata nei Melanomi di spessore > 1 mm non è un fattore prognostico indipendente e che che spesso si associa ad una bassa incidenza di riscontrare il linfonodo sentinela positvo.
Abstract
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.
