A Prospective, Multicenter Analysis of Recurrence-Free Survival After Sentinel Lymph Node Biopsy Decisions Influenced by the 31-GEP

Cancer Med. 2025 Apr;14(7):e70839. doi: 10.1002/cam4.70839.

Abstract

Background: Although most patients with cutaneous melanoma (CM) will have a negative sentinel lymph node biopsy (SLNB), up to 20%-30% of these patients will recur. The 31-gene expression profile (31-GEP) test has been prospectively validated to identify patients at low (Class 1A), intermediate (Class 1B/2A), and high (Class 2B) risk of SLN positivity and recurrence.

Methods: DECIDE is a prospective, multicenter study to assess the effect of 31-GEP testing on SLNB performance rates in patients with T1-T2 tumors considering SLNB and to study long-term outcomes. Here, we assessed outcomes in patients with a Class 1A 31-GEP result (n = 130).

Results: Of Class 1A patients, 63 had an SLNB, with a 3.2% SLN positivity rate (2/63). No Class 1A patients, regardless of SLN status, experienced a recurrence (2-year median follow-up).

Conclusions: These results are consistent with previous studies that showed the 31-GEP can identify patients at low risk of SLN positivity and recurrence.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Gene Expression Profiling* / methods
  • Humans
  • Male
  • Melanoma* / genetics
  • Melanoma* / mortality
  • Melanoma* / pathology
  • Middle Aged
  • Neoplasm Recurrence, Local* / epidemiology
  • Neoplasm Recurrence, Local* / genetics
  • Neoplasm Recurrence, Local* / pathology
  • Prospective Studies
  • Sentinel Lymph Node / pathology
  • Sentinel Lymph Node Biopsy*
  • Skin Neoplasms* / genetics
  • Skin Neoplasms* / mortality
  • Skin Neoplasms* / pathology
  • Transcriptome

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