TY - JOUR
T1 - Prognostic implications of anatomic location of primary cutaneous melanoma of 1 mm or thicker
AU - Callender, Glenda G.
AU - Egger, Michael E.
AU - Burton, Alison L.
AU - Scoggins, Charles R.
AU - Ross, Merrick I.
AU - Stromberg, Arnold J.
AU - Hagendoorn, Lee
AU - Robert Martin, C. G.
AU - McMasters, Kelly M.
PY - 2011/12
Y1 - 2011/12
N2 - Background: Breslow thickness, ulceration, and sentinel lymph node (SLN) status are well established as the most important prognostic factors for patients with cutaneous melanoma. Anatomic location of the primary tumor is generally considered to play a minor role in determining prognosis compared with these other factors. This analysis was performed to better define the influence of anatomic location of the primary melanoma on prognosis. Methods: In this post hoc analysis of a prospective randomized trial that included patients ages 18 to 70 years with melanomas 1 mm or greater in Breslow thickness, all patients underwent SLN biopsy and completion lymphadenectomy if tumor-positive SLN were found. KaplanMeier survival analysis and univariate and multivariate analyses were performed to evaluate factors predictive of disease-free survival (DFS), local and in-transit recurrence-free survival (LITRFS), and overall survival (OS). Results: A total of 2,500 patients were included in this analysis with a median follow-up period of 68 months. Anatomic locations included head, neck, trunk, upper extremity, and lower extremity. Age, Breslow thickness, and percentage of patients with a positive SLN were significantly different by anatomic location on univariate analysis, as were positive SLN status, presence of regression, sex, and histologic subtype (P <.0001). On multivariate analysis, anatomic location was an independent predictor of SLN status (P <.0001), DFS (P =.045), LITRFS (P =.023), and OS (P <.0001). By KaplanMeier analysis, anatomic location was associated significantly with DFS, LITRFS, and OS. Conclusions: Anatomic location of the primary melanoma is an important independent predictor of SLN status and prognosis. Patients with primary melanomas of the head/neck and trunk have a worse prognosis than primary melanomas of other anatomic locations.
AB - Background: Breslow thickness, ulceration, and sentinel lymph node (SLN) status are well established as the most important prognostic factors for patients with cutaneous melanoma. Anatomic location of the primary tumor is generally considered to play a minor role in determining prognosis compared with these other factors. This analysis was performed to better define the influence of anatomic location of the primary melanoma on prognosis. Methods: In this post hoc analysis of a prospective randomized trial that included patients ages 18 to 70 years with melanomas 1 mm or greater in Breslow thickness, all patients underwent SLN biopsy and completion lymphadenectomy if tumor-positive SLN were found. KaplanMeier survival analysis and univariate and multivariate analyses were performed to evaluate factors predictive of disease-free survival (DFS), local and in-transit recurrence-free survival (LITRFS), and overall survival (OS). Results: A total of 2,500 patients were included in this analysis with a median follow-up period of 68 months. Anatomic locations included head, neck, trunk, upper extremity, and lower extremity. Age, Breslow thickness, and percentage of patients with a positive SLN were significantly different by anatomic location on univariate analysis, as were positive SLN status, presence of regression, sex, and histologic subtype (P <.0001). On multivariate analysis, anatomic location was an independent predictor of SLN status (P <.0001), DFS (P =.045), LITRFS (P =.023), and OS (P <.0001). By KaplanMeier analysis, anatomic location was associated significantly with DFS, LITRFS, and OS. Conclusions: Anatomic location of the primary melanoma is an important independent predictor of SLN status and prognosis. Patients with primary melanomas of the head/neck and trunk have a worse prognosis than primary melanomas of other anatomic locations.
KW - Anatomic location
KW - Anatomic site
KW - Melanoma
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=82655171818&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=82655171818&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2011.06.048
DO - 10.1016/j.amjsurg.2011.06.048
M3 - Article
C2 - 22137134
AN - SCOPUS:82655171818
SN - 0002-9610
VL - 202
SP - 659
EP - 665
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 6
ER -