Prognostic impact of regression in patients with primary cutaneous melanoma >1 mm in thickness

Publication date: Available online 14 November 2018

Source: Journal of the American Academy of Dermatology

Author(s): Simone Ribero, Francesca Galli, Simona Osella-Abate, Luca Bertero, Laura Cattaneo, Barbara Merelli, Carlo Tondini, Laura Ghilardi, Vincenzo De Giorgi, Marcella Occelli, Pietro Quaglino, Paola Cassoni, Giuseppe Palmieri, Daniela Massi, Mario Mandala, Paola Queirolo, Ignazio Stanganelli, Gerardo Botti, Corrado Caracò, Vanna Chiarion Sileni

Background

The impact of histologic regression on sentinel lymph node biopsy (SLNB) status and on clinical outcome is uncertain.

Objective

To investigate whether and to what extent regression <75% is able to predict SLNB status and clinical outcome of patients with melanoma >1-mm thick.

Methods

The study included patients with diagnoses given at 4 centers of the Italian Melanoma Intergroup. Univariate and multivariate Cox proportional hazard models stratified by center were used to analyze the effect of regression on disease-free interval and melanoma-specific survival.

Results

Out of 1182 patients given primary cutaneous melanoma diagnoses during 1998-2015 with a Breslow thickness >1 mm, 954 (304 with and 650 without regression) were included in the analysis. The proportion of patients with a positive SLNB was lower in patients with regression than without (24.4% vs 31.6%, chi-squared test P = .0368). At multivariate analysis, no association was detected between regression and disease-free interval (hazard ratio 1.11, 95% confidence interval 0.85-1.46; P = .4509) or melanoma-specific survival (hazard ratio 1.05, 95% confidence interval 0.77-1.44; P = .7600).

Limitation

Retrospective analysis.

Conclusion

In our series, regression was not an independent prognostic factor in primary cutaneous melanoma patients with Breslow thickness >1 mm whereas it was associated with a lower incidence of SLNB positivity.

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