title: Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma.
abstract: BACKGROUND
  In patients with primary cutaneous melanoma, there is generally a delay between excisional biopsy of the primary tumour and sentinel-node biopsy. The objective of this study is to analyse the prognostic implications of this delay.
  
  
  METHODS
  This was an observational, retrospective, cohort study in four tertiary referral hospitals. A total of 1963 patients were included. The factor of interest was the interval between the date of the excisional biopsy of the primary melanoma and the date of the sentinel-node biopsy (delay time) in the prognosis. The primary outcome was melanoma-specific survival and disease-free survival.
  
  
  RESULTS
  A delay time of 40 days or less (hazard ratio (HR), 1.7; confidence interval (CI), 1.2-2.5) increased Breslow thickness (Breslow ⩾ 2 mm, HR, > 3.7; CI, 1.4-10.7), ulceration (HR, 1.6; CI, 1.1-2.3), sentinel-node metastasis (HR, 2.9; CI, 1.9-4.2), and primary melanoma localised in the head or neck were independently associated with worse melanoma-specific survival (all P < 0.03). The stratified analysis showed that the effect of delay time was at the expense of the patients with a negative sentinel-node biopsy and without regression.
  
  
  CONCLUSIONS
  Early sentinel-node biopsy is associated with worse survival in patients with cutaneous melanoma.
authors.affiliation: Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain. Electronic address: antoniotejera@aedv.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tejera-Vaquerizo
authors.affiliation: Department of Dermatology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain. Electronic address: eduardo_nagore@ono.com.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Nagore
authors.affiliation: Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain. Electronic address: susipuig@gmail.com.
authors.forename: Susana
authors.initials: S
authors.lastname: Puig
authors.affiliation: Department of Dermatology, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France. Electronic address: caroline.robert@gustaveroussy.fr.
authors.forename: Caroline
authors.initials: C
authors.lastname: Robert
authors.affiliation: Service de dermatologie générale et oncologique, Hôpital Ambroise-Paré, Université de Versailles, Boulogne cedex, France. Electronic address: Philippe.saiag@uvsq.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Saiag
authors.affiliation: Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain. Electronic address: paulamcuevas@hotmail.com.
authors.forename: Paula
authors.initials: P
authors.lastname: Martín-Cuevas
authors.affiliation: Servicio de Anatomía Patológica, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain. Electronic address: elenag313@yahoo.es.
authors.forename: Elena
authors.initials: E
authors.lastname: Gallego
authors.affiliation: Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain. Electronic address: eherreraacosta@gmail.com.
authors.forename: Enrique
authors.initials: E
authors.lastname: Herrera-Acosta
authors.affiliation: Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain. Electronic address: jaguilera@uma.es.
authors.forename: José
authors.initials: J
authors.lastname: Aguilera
authors.affiliation: Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain. Electronic address: jmalvehy@gmail.com.
authors.forename: Josep
authors.initials: J
authors.lastname: Malvehy
authors.affiliation: Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain. Electronic address: criscarrer@yahoo.es.
authors.forename: Cristina
authors.initials: C
authors.lastname: Carrera
authors.affiliation: Department of Surgery, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France. Electronic address: Andrea.cavalcanti@gustaveroussy.fr.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cavalcanti
authors.affiliation: Departamento de Cirugía, Hospital Clínic, Universidad de Barcelona, Villarroel 170, 08036 Barcelona, Spain. Electronic address: rrull@clinic.ub.es.
authors.forename: Ramón
authors.initials: R
authors.lastname: Rull
authors.affiliation: Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain. Electronic address: vilalta@cancerpiel.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vilalta-Solsona
authors.affiliation: Biostatistics and Epidemiology Unit, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France. Electronic address: Emilie.lannoy@gustaveroussy.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Lannoy
authors.affiliation: Department of Dermatology, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France. Electronic address: celine.boutros@gustaveroussy.fr.
authors.forename: Celine
authors.initials: C
authors.lastname: Boutros
authors.affiliation: Department of Dermatology, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France. Electronic address: naima.benannoune@gustaveroussy.fr.
authors.forename: Naima
authors.initials: N
authors.lastname: Benannoune
authors.affiliation: Department of Pathology, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France. Electronic address: gorana.tomasic@gustaveroussy.fr.
authors.forename: Gorana
authors.initials: G
authors.lastname: Tomasic
authors.affiliation: Service de Biostatistique et Informatique Médicale, Hôpital Ambroise-Paré, Boulogne, France. Electronic address: Philippe.aegerter@apr.aphp.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Aegerte
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínic Barcelona, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain. Electronic address: svidal@clinic.ub.es.
authors.forename: Sergi
authors.initials: S
authors.lastname: Vidal-Sicart
authors.affiliation: Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain. Electronic address: peppalau@gmail.com.
authors.forename: Josep
authors.initials: J
authors.lastname: Palou
authors.affiliation: Departamento de Anatomía Patológica, Universidad de Barcelona, Villarroel 170, 08036 Barcelona, Spain. Electronic address: lalos@clinic.ub.es.
authors.forename: L Lúcia
authors.initials: LL
authors.lastname: Alos
authors.affiliation: Department of Dermatology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain. Electronic address: celiareq@hotmail.com.
authors.forename: Celia
authors.initials: C
authors.lastname: Requena
authors.affiliation: Departamento de Anatomía Patológica, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain. Electronic address: victortraves@telefonica.net.
authors.forename: Víctor
authors.initials: V
authors.lastname: Traves
authors.affiliation: Departamento de Otorrinolaringología, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain. Electronic address: apmocholi@gmail.com.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Pla
authors.affiliation: Departamento de Cirugía, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain. Electronic address: ibolumar@yahoo.es.
authors.forename: Isidro
authors.initials: I
authors.lastname: Bolumar
authors.affiliation: Departamento de Oncología Médica, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain. Electronic address: vsoriano-fivo@hotmail.com.
authors.forename: Virtudes
authors.initials: V
authors.lastname: Soriano
authors.affiliation: Department of Dermatology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain. Electronic address: guillencar@gmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Guillén
authors.affiliation: Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain. Electronic address: eherrera@uma.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Herrera-Ceballos
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005602:France; D049690:History, Ancient; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D013030:Spain; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: Melanoma; Prognosis; Sentinel lymph node; Skin surgery; Waiting list