Long-term outcomes after amputation and sentinel node biopsy for subungual melanoma: A single-institution series
The American Journal of Surgery(2024)
摘要
Background
Subungual melanoma (SUM) is a rare tumor with historically poor outcomes. Thus, the benefit of proximal versus distal amputation in SUM remains unclear.
Methods
We performed a retrospective review of our prospectively-maintained institutional melanoma database, including SUM and non-subungual acral melanoma (AM) patients who underwent sentinel lymph node biopsy (SLNB) between 1999 and 2022. All SUMs had distal joint or proximal amputations. Primary endpoints were overall survival (OS) and recurrence free survival (RFS). Kaplan-Meier estimates, and Cox univariate and multivariate analyses were performed. Tests were repeated on propensity score matched (PSM) populations in a 2:1 ratio.
Results
123 patients underwent resection with SLNB for SUM (n = 27) and AM (n = 96). Median follow-up was 9.2 years. Unadjusted median OS was 149.1 months for AM and 198.1 months for SUM. In the PSM comparison, median OS and RFS remained comparable between SUM and AM (149.5 months versus 198.1 months; p = 0.612). Sentinel node positivity was associated with significantly worse overall survival outcome (Hazard Ratio 5.49; CI (1.59–18.97), p = 0.007). In the PSM population, male sex was also associated with a significant hazard of death (HR 3.00, CI (1.03–8.71), p = 0.043). Proximal amputations were associated with significantly worse OS (p < 0.002) and RFS (p < 0.01) compared to distal amputations in SUM.
Conclusion
SUM was well-treated with distal amputations, and had better OS and RFS compared to SUM treated with proximal amputations. Sentinel lymph node status is an important prognostic factor for SUMs and AMs. SUMs can be treated similarly to AMs with comparably good long-term outcomes.
更多查看译文
关键词
Subungual melanoma,Melanoma,Acral melanoma,Acral lentiginous melanoma,Amputation,Sentinel node biopsy
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要