title: Value of sentinel lymph node biopsy and adjuvant interferon treatment in thick (>4 mm) cutaneous melanoma: an observational study.
abstract: BACKGROUND
  The role of sentinel lymph node biopsy and the benefit of immunotherapy with interferon in thick (>4 mm) melanomas remain uncertain.
  
  
  OBJECTIVE
  Our aim was to assess the value of both sentinel lymph node (SLN) biopsy and immunotherapy in the prognosis of thick melanomas.
  
  
  METHODS
  A retrospective study based on a computerized patient database in which patients have been prospectively collected since 2005 was performed. Age, sex, location, Breslow thickness, tumor ulceration, regression, Clark level, tumor infiltrating lymphocytes, tumor mitotic rate, microscopic satellite and vascular invasion were included in the analysis. Disease-free (DFS), disease-specific (DSS) and overall (OS) survivals were evaluated by the Kaplan-Meier method and Cox regression analysis.
  
  
  RESULTS
  A series of 141 patients with melanomas thicker than 4 mm were included. Multivariate regression showed a worse prognosis in SLN-positive patients with respect to SLN biopsy-negative patients (DFS, hazard ratio [HR] 2, p = 0.04; DSS, HR 2.2, p = 0.002; OS, HR 2.4, p = 0.02). The observational group was shown to have a worse prognosis than the SLN-positive group but was very similar to the clinically positive group. Immunotherapy with high-dose interferon showed a protective effect (DFS, HR 0.5, p = 0.02; DSS, HR 0.3, p = 0.001; OS, HR 0.3, p = 0.001).
  
  
  CONCLUSIONS
  Our data indicate that SLN biopsy and adjuvant interferon should be considered for patients with thick melanomas.
authors.affiliation: School of Medicine, Universidad Católica de Valencia, Valencia, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Morera-Sendra
authors.affiliation: Deparment of Dermatology. Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tejera-Vaquerizo
authors.affiliation: Department of Pathology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8 46009 Valencia, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Traves
authors.affiliation: Department of Dermatology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8 46009 Valencia, Spain.
authors.forename: Celia
authors.initials: C
authors.lastname: Requena
authors.affiliation: Department of Surgery, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8 46009 Valencia, Spain.
authors.forename: Isidro
authors.initials: I
authors.lastname: Bolumar
authors.affiliation: Department of Otorhinolaryngology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8 46009 Valencia, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Pla
authors.affiliation: Department of Nuclear Medicine, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8 46009 Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Vázquez
authors.affiliation: Department of Oncology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8 46009 Valencia, Spain.
authors.forename: Virtudes
authors.initials: V
authors.lastname: Soriano
authors.affiliation: School of Medicine, Universidad Católica de Valencia, Valencia, Spain, Department of Dermatology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8 46009 Valencia, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Nagore
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D016019:Survival Analysis
chemical_list: D000276:Adjuvants, Immunologic; D000970:Antineoplastic Agents; D007372:Interferons
keywords: prognosis; sentinel lymph node biopsy; survival; thick melanoma