Sentinel Lymph Node Biopsy for T1b Melanoma: Balancing Prognostic Value and Cost.

Annals of Surgical Oncology
Yinin HuMary S Brady

Abstract

The purpose of this study is to report the additional prognostic information and cost associated with sentinel lymph node biopsy (SLNB) for patients with T1b melanoma. An institutional database was queried for patients with T1b melanoma (0.8-1.0 mm or < 0.8 mm with ulceration) with at least 5 years of follow-up. Results of SLNB, completion lymphadenectomy (CLND), recurrence, and melanoma-specific survival (MSS) were assessed. Institutional costs of melanoma care were converted to Medicare proportional dollars. A Markov model was created to estimate long-term costs. Among the total 392 patients, 238 underwent SLNB. Median follow-up was 10.5 years. SLNB was positive in 19 patients (8.0%). Patients who underwent SLNB had higher 10-year nodal recurrence-free survival (98.6% vs. 91.2%, p < 0.001) but not MSS (94.4% vs. 93.2%, p = 0.55). Ulceration (HR 4.7, p = 0.022) and positive sentinel node (HR 11.5, p < 0.001) were associated with worse MSS. Estimates for 5-year costs reflect a fourfold increase in total costs of care associated with SLNB. However, a treatment plan that forgoes adjuvant therapy for resected stage IIIA melanoma but offers systemic therapy for a node-basin recurrence would nullify the additional cost of SLNB. SLNB...Continue Reading

References

Apr 1, 1992·Archives of Surgery·D L MortonA J Cochran
Mar 29, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Richard J BleicherDonald L Morton
Nov 8, 2003·Surgery·Doreen M AgneseMichael J Walker
Feb 18, 2006·Annals of Surgical Oncology·Sandra L WongDaniel G Coit
Jun 22, 2006·Annals of Surgical Oncology·Jaime M RanieriJohn J Coleman
Sep 29, 2006·The New England Journal of Medicine·Donald L MortonUNKNOWN MSLT Group
Apr 3, 2007·International Journal of Cancer. Journal International Du Cancer·Hans Starz, Bernd-Ruediger Balda
Sep 17, 2008·Archives of Surgery·Byron E WrightDonald L Morton
Nov 6, 2009·European Journal of Dermatology : EJD·Lenka VermeerenKarel Hulsewé
Jul 7, 2012·Annals of Surgical Oncology·Dale HanJonathan S Zager
Aug 8, 2012·Annals of Surgical Oncology·Jeffrey E GershenwaldJohn F Thompson
Apr 24, 2013·Clinics in Dermatology·Merrick I Ross, Jeffrey E Gershenwald
Oct 15, 2013·Annals of Surgical Oncology·Edmund K BartlettGiorgos C Karakousis
Nov 6, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Dale HanStanley P Leong
Feb 26, 2015·Journal of Surgical Oncology·Yinin HuCraig L Slingluff
Nov 3, 2016·Annals of Surgical Oncology·Erin CordeiroFrances C Wright
Jul 18, 2016·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·J A MoodyJ T Hardwicke
Jun 8, 2017·The New England Journal of Medicine·Mark B FariesRobert M Elashoff
Oct 14, 2017·CA: a Cancer Journal for Clinicians·Jeffrey E GershenwaldUNKNOWN for members of the American Joint Committee on Cancer Melanoma Expert Panel and the International Melanoma Database and Disc
Apr 17, 2018·The New England Journal of Medicine·Alexander M M EggermontCaroline Robert

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Citations

Jun 13, 2020·Annals of Surgical Oncology·Yinin Hu, Mary S Brady
Apr 24, 2021·Annals of Surgical Oncology·Michael E Egger
Jun 11, 2021·Journal of Surgical Oncology·Jatin NarangLuke D Rothermel

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