Scholarlink

Background <p>Sentinel node biopsy (SNB) predicts long-term melanoma outcomes and advises referrals for adjuvant systemic therapy (AST). Concerns regarding the impact of treatment delays on clinical outcomes remain.</p> Methods <p>A UK retrospective cohort study at a supra-regional centre was performed, including 1625 patients listed for SNB between 2010-23. Three parameters were investigated: disease progression, micrometastatic burden, and disease-specific survival. Time-to-SNB was stratified as early (≤90days) or late (&gt;90days), with a subgroup analysis accounting for AST use (2017-23). Sensitivity analyses calculated a wait-time threshold beyond which worsens survival outcomes.</p> Results <p>Median time-to-SNB was 68 days (IQR = 51–95) and follow-up 75 months (IQR = 35–115). Late surgery correlated with disease progression before surgery (0.34% versus 1.54%; OR = 4.31; <i>p</i> = 0.022); larger micrometastases (1.40 mm vs. 2.95 mm; <i>p</i> = 0.003), and increased high-risk micrometastatic deposits &gt;1 mm (55.2% vs. 69.1%; OR = 2.04; <i>p</i> = 0.014). For patients post-2016, longer wait-times correlated with poorer DSS (HR = 1.01 (1.00–1.02); <i>p</i> = 0.011 for diagnosis-to-SNB; and HR = 1.01 (1.00–1.02); <i>p</i> = 0.016 for primary excision-to-SNB). Sensitivity analyses calculated ≤68-days from diagnosis (HR = 3.17 (1.19–8.46); <i>p</i> = 0.021) and ≤82-days from excision (HR = 2.94 (1.10–7.87); <i>p</i> = 0.032) as optimal treatment thresholds.</p> Conclusion <p>Surgical delays correlated with harm: disease progression, increased tumour burden and worse survival. SNB should occur within 68 days from diagnosis and/or 82 days from excision biopsy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Implications of wait times for sentinel node biopsy on melanoma disease progression, micrometastatic tumour burden and survival outcomes in the modern treatment era

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月16日

查看全文
  • Sofia O. Breeze,
  • Martin J. Heaton,
  • Andrew P. Snelling,
  • Jennifer J. Garioch,
  • Jenny P. Nobes,
  • Marc D. Moncrieff

摘要

Background

Sentinel node biopsy (SNB) predicts long-term melanoma outcomes and advises referrals for adjuvant systemic therapy (AST). Concerns regarding the impact of treatment delays on clinical outcomes remain.

Methods

A UK retrospective cohort study at a supra-regional centre was performed, including 1625 patients listed for SNB between 2010-23. Three parameters were investigated: disease progression, micrometastatic burden, and disease-specific survival. Time-to-SNB was stratified as early (≤90days) or late (>90days), with a subgroup analysis accounting for AST use (2017-23). Sensitivity analyses calculated a wait-time threshold beyond which worsens survival outcomes.

Results

Median time-to-SNB was 68 days (IQR = 51–95) and follow-up 75 months (IQR = 35–115). Late surgery correlated with disease progression before surgery (0.34% versus 1.54%; OR = 4.31; p = 0.022); larger micrometastases (1.40 mm vs. 2.95 mm; p = 0.003), and increased high-risk micrometastatic deposits >1 mm (55.2% vs. 69.1%; OR = 2.04; p = 0.014). For patients post-2016, longer wait-times correlated with poorer DSS (HR = 1.01 (1.00–1.02); p = 0.011 for diagnosis-to-SNB; and HR = 1.01 (1.00–1.02); p = 0.016 for primary excision-to-SNB). Sensitivity analyses calculated ≤68-days from diagnosis (HR = 3.17 (1.19–8.46); p = 0.021) and ≤82-days from excision (HR = 2.94 (1.10–7.87); p = 0.032) as optimal treatment thresholds.

Conclusion

Surgical delays correlated with harm: disease progression, increased tumour burden and worse survival. SNB should occur within 68 days from diagnosis and/or 82 days from excision biopsy.