Long-Term Survival Analysis and Clinical Follow-Up in Acral Lentiginous Malignant Melanoma Undergoing Sentinel Lymph Node Biopsy in Korean Patients
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Background: In cutaneous malignant melanoma (MM) withclinically uninvolved regional lymph nodes, sentinel lymphnode (SLN) status is the most powerful indicator of bothoverall survival (OS) and disease-free survival (DFS). However,no studies on the long-term survival and clinical follow-up ofKorean patients with acral lentiginous MM (ALM) undergoingSLN biopsy (SLNB) have been published. Objective:The purpose of this study was to investigate the clinicalprognosis and long-term survival of Korean patients withALM according to SLN status. Methods: Thirty-four ALMpatients undergoing SLNB were included in this study. Weevaluated clinical and histopathological follow-up data suchas the stage of disease, treatment, recurrence, and metastasis,and analyzed OS and DFS according to SLN status. Results:The median follow-up time was 60.5 months (range 3∼127months). Positive SLNs were noted in 14 patients (41.2%). Patients with negative SLNs had better OS and DFS thanthose with positive SLNs (p＜0.05). Increased Breslowthickness was associated with short OS and DFS (p＜0.05),and female patients showed better DFS than male patients (p＜0.05). Conclusion: To our knowledge, this is the first studyon the long-term survival and clinical follow-up of patientsundergoing SLNB for ALM in Korea. Our findings show thatSLN status is an important prognostic factor for predicting OSand DFS.
Abstract
Background: In cutaneous malignant melanoma (MM) withclinically uninvolved regional lymph nodes, sentinel lymphnode (SLN) status is the most powerful indicator of bothoverall survival (OS) and disease-free survival (DFS). However,no studies on the long-term survival and clinical follow-up ofKorean patients with acral lentiginous MM (ALM) undergoingSLN biopsy (SLNB) have been published. Objective:The purpose of this study was to investigate the clinicalprognosis and long-term survival of Korean patients withALM according to SLN status. Methods: Thirty-four ALMpatients undergoing SLNB were included in this study. Weevaluated clinical and histopathological follow-up data suchas the stage of disease, treatment, recurrence, and metastasis,and analyzed OS and DFS according to SLN status. Results:The median follow-up time was 60.5 months (range 3∼127months). Positive SLNs were noted in 14 patients (41.2%). Patients with negative SLNs had better OS and DFS thanthose with positive SLNs (p＜0.05). Increased Breslowthickness was associated with short OS and DFS (p＜0.05),and female patients showed better DFS than male patients (p＜0.05). Conclusion: To our knowledge, this is the first studyon the long-term survival and clinical follow-up of patientsundergoing SLNB for ALM in Korea. Our findings show thatSLN status is an important prognostic factor for predicting OSand DFS.
참고문헌 (23)
- Johnson DS, "Malignant melanoma in non-Caucasians: experience from Hawaii", Surg Clin North Am, 83, pp.275~282 (2003)
- Qiu D, "Comparison of time trends in skin cancer incidence (1973-97) in East Asia, Europe and USA, from cancer incidence in five continents vol. IV-VIII", Jpn J Clin Oncol, 38, pp.234~236 (2008)
- 노미령, "Treatment and Outcomes of Melanoma in Acral Location in Korean Patients", Yonsei Medical Journal, 51(4), pp.562~568 (2010), 연세대학교의과대학
- Wong SL, "Sentinel lymph node biopsy for melanoma: American Society of Clinical Oncology and Society of Surgical Oncology joint clinical practice guideline", J Clin Oncol, 30, pp.2912~2918 (2012)
- Wisco OJ, "Prognostic factors for melanoma", Dermatol Clin, 30, pp.469~485 (2012)
- Morton DL, "Technical details of intraoperative lymphatic mapping for early stage melanoma", Arch Surg, 127, pp.392~399 (1992)
- Balch CM, "Final version of 2009 AJCC melanoma staging and classification", J Clin Oncol, 27, pp.6199~6206 (2009)
- Morton DL, "Sentinel-node biopsy or nodal observation in melanoma", N Engl J Med, 355, pp.1307~1317 (2006)
- Debarbieux S, "Sentinel lymph node biopsy in melanoma: a micromorphometric study relating to prognosis and completion lymph node dissection", Br J Dermatol, 157, pp.58~67 (2007)
- Halsted WS, "I. The results of radical operations for the cure of carcinoma of the breast", Ann Surg, 46, pp.1~19 (1907)
- Snow H, "Abstract of a lecture on melanotic cancerous disease", Lancet, 140, pp.872~874 (1892)
- Breslow A, "Tumor thickness, level of invasion and node dissection in stage I cutaneous melanoma", Ann Surg, 182, pp.572~575 (1975)
- Crowley NJ, "The role of elective lymph node dissection in the management of patients with thick cutaneous melanoma", Cancer, 66, pp.2522~2527 (1990)
- Beitsch P, "Operative morbidity and risk factor assessment in melanoma patients undergoing inguinal lymph node dissection", Am J Surg, 164, pp.462~465 (1992)
- Stebbins WG, "Sentinel lymph node biopsy and melanoma: 2010 update part I", J Am Acad Dermatol, 62, pp.723~734 (2010)
- Medalie NS, "Sentinel lymph node biopsy has no benefit for patients with primary cutaneous melanoma metastatic to a lymph node: an assertion based on comprehensive, critical analysis: part I", Am J Dermatopathol, 25, pp.399~417 (2003)
- Socrier Y, "Histological regression in primary melanoma:not a predictor of sentinel lymph node metastasis in a cohort of 397 patients", Br J Dermatol, 162, pp.830~834 (2010)
- Phan A, "Acral lentiginous melanoma: histopathological prognostic features of 121 cases", Br J Dermatol, 157, pp.311~318 (2007)
- Noro S, "Clinicopathological significance of sentinel node biopsy in Japanese patients with cutaneous malignant melanoma", J Dermatol, 38, pp.76~83 (2011)
- Namikawa K, "Prediction of additional lymph node positivity and clinical outcome of micrometastases in sentinel lymph nodes in cutaneous melanoma: a multi-institutional study of 450patients in Japan", J Dermatol, 39, pp.130~137 (2012)
- de Vries M, "Long-term follow-up reveals that ulceration and sentinel lymph node status are the strongest predictors for survival in patients with primary cutaneous melanoma", Eur J Surg Oncol, 37, pp.681~687 (2011)
- Balch CM, "Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system", J Clin Oncol, 19, pp.3622~3634 (2001)
- Garbe C, "Primary cutaneous melanoma. Identification of prognostic groups and estimation of individual prognosis for 5093patients", Cancer, 75, pp.2484~2491 (1995)