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Study Aims to Identify Melanoma Patients With High-Risk Disease

Patients with AJCC IIIA and sentinel node metastatic tumor deposits ≥0.3 mm have lower five-year disease-specific survival rates

By Physician’s Briefing Staff | August 31, 2022

Patients with early-stage melanoma with low disease burden sentinel node (SN) micrometastases (American Joint Committee on Cancer [AJCC] stage IIIA disease) with SN tumor deposits ≥0.3 mm have lower survival, according to a study published online July 18 in the Journal of Clinical Oncology .

Marc D. Moncrieff, M.D., from the Norfolk and Norwich University Hospital NHS Trust in the United Kingdom, and colleagues recruited 3,607 adult patients with pathologic stage pT1b/pT2a primary cutaneous melanomas who underwent SN biopsy between 2005 and 2020 from an intercontinental consortium of nine high-volume cancer centers. Patients were followed for a median of 34 months.

The researchers found no significant survival differences between N1a and N2a subgroups. An SN tumor deposit maximum dimension of 0.3 mm was identified as the optimal cut point for stratifying survival. For patients with SN metastatic tumor deposits ≥0.3 mm and <0.3 mm, five-year disease-specific survival rates were 80.3 and 94.1 percent, respectively (hazard ratio, 1.26). Findings were similar for overall disease-free and distant metastasis-free survival. No survival differences were seen between the AJCC IB patients and low-risk (<0.3 mm) AJCC IIIA patients.

"We suggest that early-stage, AJCC IIIA patients with micrometastases of maximum tumor dimension ≥0.3 mm should be considered for adjuvant systemic therapy or enrollment into a clinical trial, whereas patients with micrometastases of maximum tumor dimension <0.3 mm can be managed in a similar fashion to their SN-negative, AJCC IB counterparts," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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