Evidence map›Paper›PMID 28668274›Full record

ArticleJournal of the American College of Surgeons2017

Impact of Time Between Diagnosis and SLNB on Outcomes in Cutaneous Melanoma.

Daniel W Nelson, Stacey Stern, David E Elashoff, Robert Elashoff, John F Thompson, Nicola Mozzillo, Omgo E Nieweg, Harald J Hoekstra, Alistair J Cochran, Mark B Faries

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American College of Surgeons, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Daniel W NelsonDivision of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA.
Stacey SternDepartment of Biostatistics, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA.
David E ElashoffDepartment of Biostatistics, University of California Los Angeles, Los Angeles, CA.
Robert ElashoffDepartment of Biostatistics, University of California Los Angeles, Los Angeles, CA.
John F ThompsonMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Nicola MozzilloIstituto Nazionale dei Tumori Napoli, Napoli, Italy.
Omgo E NiewegMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Harald J HoekstraDivision of Surgical Oncology, Groningen University, University Medical Center Groningen, Groningen, The Netherlands.
Alistair J CochranDepartment of Pathology, University of California Los Angeles, Los Angeles, CA.
Mark B FariesDivision of Surgical Oncology, The Angeles Clinic and Research Institute, Los Angeles, CA. Electronic address: mfaries@theangelesclinic.org.

Funding

SURGICAL ONCOLOGY WITH COMBINATION THERMO-CHEMOTHERAPYP01CA029605 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI COCHRAN, ALISTAIR JOHN · 1985 to 2013
$75.2M
Multicenter Selective Lymphadenectomy Trial (MSLT II) in MelanomaR01CA189163 · NCI · SAINT JOHN'S CANCER INSTITUTE · PI FARIES, MARK B · 2014 to 2018
$8.1M
NCI NIH HHS P01 CA029605NCI NIH HHS R01 CA189163
6 · The paper itself

Abstract

backgroundHypothetically, delay between melanoma diagnosis and SLNB could affect outcomes, either adversely by allowing growth and dissemination of metastases, or beneficially by allowing development of an anti-melanoma immune response. Available data are conflicting about the effect of SLNB delay on patient survival. Our objective was to determine whether delay between initial diagnosis and SLNB affects outcomes in patients with cutaneous melanoma. STUDY

designWe performed query and analysis of a large prospectively maintained database of patients with primary cutaneous melanomas undergoing SLNB. An independent dataset from MSLT-1 (Multicenter Selective Lymphadenectomy Trial-1) was used for validation. Primary outcomes included disease-free survival and melanoma-specific survival.

resultsEarly and delayed SLNB were defined as less than 30 and 30 or more days from initial diagnosis, respectively. There were 2,483 patients that met inclusion criteria. Positive sentinel lymph nodes were identified in 17.4% (n = 432). Among all patients, 42% had SLNB 30 or more days after diagnosis and 37% of positive sentinel lymph nodes were at 30 or more days. No differences in sex, anatomic site, or histopathologic features were identified between the 2 groups. There was no difference in melanoma-specific survival or disease-free survival between those undergoing early or delayed SLNB. Examination of MSLT-1 trial data similarly demonstrated no difference in survival outcomes.

conclusionsThis, the largest study on this subject to date, found no adverse impact on long-term clinical outcomes of patients due to delay of SLNB beyond 30 days. The MSLT-1 data confirm this result. Patients can be reassured that if the operation is performed 30 or more days after diagnosis, it will not cause harm.

Indexed as

AdolescentAdultAgedAged, 80 and overChildChild, PreschoolDelayed DiagnosisDisease-Free SurvivalFemaleHumansMaleMelanomaMiddle AgedRetrospective StudiesSentinel Lymph Node BiopsySkin Neoplasms

Identifiers

PMID28668274
PMCPMC5553862

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.