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Clinical Outcomes a...
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Moncrieff, Marc D
(författare)
Clinical Outcomes and Risk Stratification of Early-Stage Melanoma Micrometastases From an International Multicenter Study: Implications for the Management of American Joint Committee on Cancer IIIA Disease.
- Artikel/kapitelEngelska2022
Förlag, utgivningsår, omfång ...
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LIBRIS-ID:oai:gup.ub.gu.se/321588
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https://gup.ub.gu.se/publication/321588URI
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https://doi.org/10.1200/JCO.21.02488DOI
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Indications for offering adjuvant systemic therapy for patients with early-stage melanomas with low disease burden sentinel node (SN) micrometastases, namely, American Joint Committee on Cancer (AJCC; eighth edition) stage IIIA disease, are presently controversial. The current study sought to identify high-risk SN-positive AJCC stage IIIA patients who are more likely to derive benefit from adjuvant systemic therapy.Patients were recruited from an intercontinental (Australia/Europe/North America) consortium of nine high-volume cancer centers. All were adult patients with pathologic stage pT1b/pT2a primary cutaneous melanomas who underwent SN biopsy between 2005 and 2020. Patient data, primary tumor and SN characteristics, and survival outcomes were analyzed.Three thousand six hundred seven patients were included. The median follow-up was 34 months. Pairwise disease comparison demonstrated no significant survival difference between N1a and N2a subgroups. Survival analysis identified a SN tumor deposit maximum dimension of 0.3 mm as the optimal cut point for stratifying survival. Five-year disease-specific survival rates were 80.3% and 94.1% for patients with SN metastatic tumor deposits ≥ 0.3 mm and < 0.3 mm, respectively (hazard ratio, 1.26 [1.11 to 1.44]; P < .0001). Similar findings were seen for overall disease-free and distant metastasis-free survival. There were no survival differences between the AJCC IB patients and low-risk (< 0.3 mm) AJCC IIIA patients. The newly identified high-risk (≥ 0.3 mm) subgroup comprised 271 (66.4%) of the AJCC IIIA cohort, whereas only 142 (34.8%) patients had SN tumor deposits > 1 mm in maximum dimension.Patients with AJCC IIIA melanoma with SN tumor deposits ≥ 0.3 mm in maximum dimension are at higher risk of disease progression and may benefit from adjuvant systemic therapy or enrollment into a clinical trial. Patients with SN deposits < 0.3 mm in maximum dimension can be managed similar to their SN-negative, AJCC IB counterparts, thereby avoiding regular radiological surveillance and more intensive follow-up.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Lo, Serigne N
(författare)
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Scolyer, Richard A
(författare)
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Heaton, Martin J
(författare)
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Nobes, Jenny P
(författare)
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Snelling, Andrew P
(författare)
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Carr, Michael J
(författare)
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Nessim, Carolyn
(författare)
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Wade, Ryckie
(författare)
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Peach, A Howard
(författare)
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Kisyova, Rumi
(författare)
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Mason, Jennifer
(författare)
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Wilson, Ewan D
(författare)
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Nolan, Grant
(författare)
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Pritchard Jones, Rowan
(författare)
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Johansson, Iva,1973Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xjohiv
(författare)
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Olofsson Bagge, Roger,1978Gothenburg University,Göteborgs universitet,Sahlgrenska Centrum för Cancerforskning (SCCR),Sahlgrenska Center for Cancer Research (SCCR)(Swepub:gu)xoloro
(författare)
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Wright, Lucie J
(författare)
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Patel, Nakul G
(författare)
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Sondak, Vernon K
(författare)
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Thompson, John F
(författare)
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Zager, Jonathan S
(författare)
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Göteborgs universitetInstitutionen för kliniska vetenskaper
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Journal of clinical oncology : official journal of the American Society of Clinical Oncology40:34, s. 3940-39511527-7755
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Moncrieff, Marc ...
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Lo, Serigne N
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Scolyer, Richard ...
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Heaton, Martin J
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Nobes, Jenny P
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Snelling, Andrew ...
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visa fler...
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Carr, Michael J
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Nessim, Carolyn
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Wade, Ryckie
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Peach, A Howard
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Kisyova, Rumi
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Mason, Jennifer
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Wilson, Ewan D
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Nolan, Grant
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Pritchard Jones, ...
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Johansson, Iva, ...
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Olofsson Bagge, ...
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Wright, Lucie J
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Patel, Nakul G
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Sondak, Vernon K
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Thompson, John F
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Zager, Jonathan ...
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Göteborgs universitet