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Association of Sentinel Node Biopsy and Pathological Report Completeness with Survival Benefit for Cutaneous Melanoma and Factors Influencing Their Different Uses in European Populations.

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Date

2022-08-31

Authors

Sant, Milena
Magri, Maria Chiara
Maurichi, Andrea
Lillini, Roberto
Bento, Maria Jose
Ardanaz, Eva
Guevara, Marcela
Innos, Kaire
Marcos-Gragera, Rafael
Rubio-Casadevall, Jordi

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MDPI AG
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Abstract

Objectives: Standard care for cutaneous melanoma includes an accurate pathology report (PR) and sentinel lymph node biopsy (SLNB) for staging clinically node-negative >1 mm melanomas. We aimed to investigate the frequency of these indicators across European countries, also assessing consequences for survival. Methods: We analyzed 4245 melanoma cases diagnosed in six European countries in 2009−2013. Multivariable logistic regression was used to estimate the Odds Ratio (OR) of receiving complete PR with eight items or SLNB and model-based survival to estimate the five-year relative excess risks of death (RER). Results: Overall, 12% patients received a complete PR (range 2.3%, Estonia—20.1%, Italy); SLNB was performed for 68.8% of those with cN0cM0 stage (range 54.4%, Spain—81.7%, Portugal). The adjusted OR of receiving a complete PR was lower than the mean in Estonia (OR 0.11 (0.06−0.18)) and higher in Italy (OR 6.39 (4.90−8.34)) and Portugal (OR 1.39 (1.02−1.89)); it was higher for patients operated on in specialized than general hospitals (OR 1.42 (1.08−1.42)). In the multivariate models adjusted for age, sex, country and clinical-pathological characteristics, the RER resulted in being higher than the reference for patients not receiving a complete PR with eight items (RER 1.72 (1.08−2.72)), or for those not undergoing SLNB (RER 1.76 (1.26−2.47)) Patients with non-metastatic node-negative thickness >1 mm melanoma who did not undergo SLNB had a higher risk of death (RER (RER 1.69 (1.02−2.80)) than those who did. Conclusions: Accurate pathology profiling and SLNB carried survival benefit. Narrowing down between-countries differences in adhesion to guidelines might achieve better outcomes.

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MeSH Terms

Humans
Melanoma
Skin Neoplasms
Sentinel Lymph Node Biopsy
Logistic Models
Portugal
Spain
Estonia
Hospitals, General
Odds Ratio
Melanoma, Cutaneous Malignant
Italy
Humans
Melanoma
Skin Neoplasms
Logistic Models
Portugal
Spain
Estonia
Hospitals, General
Odds Ratio
Melanoma, Cutaneous Malignant
Italy

DeCS Terms

Biopsia del ganglio linfático
Centinela
España
Estonia
Hospitales generales
Humanos
Italia
Melanoma
Melanoma cutáneo maligno
Modelos logísticos
Neoplasias cutáneas
Oportunidad relativa
Portugal
España
Estonia
Hospitales generales
Humanos
Italia
Melanoma
Melanoma cutáneo maligno
Modelos logísticos
Neoplasias cutáneas
Oportunidad relativa
Portugal

CIE Terms

Keywords

cutaneous melanoma, excess of relative risk of death, pathology report, population-based cancer registries, relative survival, sentinel lymph node biopsy

Citation

Sant M, Magri MC, Maurichi A, Lillini R, Bento MJ, Ardanaz E, et al. The Melanoma Hr Study Working Group. Association of Sentinel Node Biopsy and Pathological Report Completeness with Survival Benefit for Cutaneous Melanoma and Factors Influencing Their Different Uses in European Populations. Cancers (Basel). 2022 Sep 8;14(18):4379.