Effect of the time interval between melanoma diagnosis and sentinel node biopsy on the size of metastatic tumour deposits in node-positive patients

Mary-Ann El Sharouni; Richard A Scolyer; Carla H van Gils; Sydney Ch'ng; Omgo E Nieweg; Thomas E Pennington; Robyn Pm Saw; Kerwin Shannon; Andrew Spillane; Jonathan Stretch; Arjen J Witkamp; Vigfús Sigurdsson; John F Thompson; Paul J van Diest; Serigne N Lo

doi:10.1016/j.ejca.2021.12.036

Effect of the time interval between melanoma diagnosis and sentinel node biopsy on the size of metastatic tumour deposits in node-positive patients

Eur J Cancer. 2022 May:167:133-141. doi: 10.1016/j.ejca.2021.12.036. Epub 2022 Feb 22.

Authors

Affiliations

¹ Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Department of Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
² Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Tissue Oncology and Diagnostic Pathology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
³ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands.
⁴ Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
⁵ Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
⁶ Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Breast and Melanoma Surgery, Royal North Shore Hospital, Sydney, NSW, Australia.
⁷ Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
⁸ Department of Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
⁹ Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia. Electronic address: john.thompson@melanoma.org.au.
¹⁰ Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
¹¹ Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

PMID: 35216870
DOI: 10.1016/j.ejca.2021.12.036

Abstract

Introduction: This study sought to assess whether the interval between diagnostic excision-biopsy of a primary melanoma and definitive wide excision with sentinel node biopsy (SNB) influenced the size of SN metastatic deposits, which might have implications for management and prognosis.

Methods: Data were collected for (i) a Dutch population-based cohort of patients treated between 2004 and 2014 who underwent SNB within 100 days of complete excision of their primary melanoma and who were SN-positive with known SN metastasis diameter (n = 1027) and (ii) a cohort from a large Australian melanoma treatment centre (n = 541) who presented in the same time period. The effects of SNB timing on the size of SN metastatic deposits were analysed.

Results: Dutch patients whose SNB was performed in the second or third months after diagnosis had significantly larger SN metastasis diameters than patients who had their SNB in the first month (median increases of 17% (95%CI -14, 60%, p = 0.211) and 71% (95%CI 15, 119%, p = 0.004), respectively). No significant difference in tumour diameter for early and late SNB was found in the Australian cohort.

Conclusions: SN metastasis diameter became progressively greater with SN biopsy in the second and third months after primary melanoma diagnosis in the larger, population-based patient cohort. An increase in metastasis diameter was not observed in the smaller, institutional cohort, possibly due to detection of larger SN metastases by routine pre-operative ultrasound, with fine-needle biopsy confirmation. These patients did not proceed to SNB and were therefore not included in the study.

Keywords: Diagnosis; Excision; Melanoma; Metastasis; Sentinel node; Size; Time.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Extranodal Extension
Humans
Lymph Node Excision
Melanoma* / pathology
Melanoma* / surgery
Neoplasms, Second Primary* / surgery
Sentinel Lymph Node Biopsy
Skin Neoplasms* / pathology
Syndrome