SURVIVAL RATE IN PATIENTS WITH MALIGNANT MELANOMA VARIABLES AND RESULTS

SURVIVAL RATE IN PATIENTS WITH MALIGNANT MELANOMA VARIABLES AND RESULTS Dr Jasminka Minic Introduction: International guidelines for patients with malignant melanoma and a positive sentinel node biopsy, (SNB) suggests a complete lymph node dissection (CLND). Less than 20% of CLNDs show additional nodal metastases and its therapeutic benefit is still discussed. This retrospective study was designed to identify the group of patients with positive sentinel lymph node, who could benefit or could be spare of CLND, according to the analysis of clinical biomarkers and histological micromorphometric characteristic of SLN, in terms of recurrence (disease free survival, DFS) and mortality (overall survival). Material and Methods: In this long term retrospective study (2000-2014), was analyzed 1615 patients with primary melanoma, out of which 583 underwent SLN biopsy. We selected 80 (out of 125) patients with positive sentinel lymph node who underwent CLND, in order to analyze tumor burden according to Rotterdam and Dewar classification, Chi-square test,Student Test, analysis of variance, Hazard ratio and Kaplan-Meier survival curves were used to compare the incidence of recurrent/metastatic disease and mortality. Results: This study showed that among demographic data, clinical biomarkers and micromorphometric histological findings, tumor burden according to the Rotterdam classification seams to be an excellent prognostic factor. On the other had location of the metastasis according to the Dewar classification is to be less significant prognostic factor in DFS and OS in metastasis patients. Conclusions: Our data, although still limited, suggest there is not a significant increase in OS and DFS after CLND performance. SNB tumor burden seems to be the most important prognostic value in OS and DFS and Breslow index appears to have no further significance as a prognostic index in SNB positive patients.