Independent prognostic impact of lympho-vascular invasion in cutaneous melanoma patients with sentinel lymph node biopsy

LUCA ROMINA; RIZZO MANGLIO; MANDO PABLO; PEREZ DE LA PUENTE CONSTANZA; BLANCO ALBANO; RIVERO SERGIO; LUTTER F.; CAPPUCCIO F.; AMAN, E.; KAPLAN JULIO; CHACON REINALDO; CHACON MATÍAS

Congreso; ESMO 2017 Congress; 2017

BackgroundIncidence of cutaneous melanoma (CM) is increasing worldwide. The primary treatment of CM is surgery. Prognosis is determined by characteristics of the lesion such as depth of invasion, ulceration and sentinel lymph node (SLN) status. The aim of this study was to analyze the prognostic impact of lympho-vascular invasion (LVI) in CM patients (pts) undergoing SLN biopsy since LVI has not been established as a clear prognostic factor in the current AJCC 8th ed. cancer staging system.MethodsRetrospective, descriptive and observational analytical study. We used the institutional database of pts with diagnosis of CM, submitted to SLN biopsy between November 1994 and August 2016. The association between pathological characteristics and SLN were analyzed using Chi2 and logistic regression model. Kaplan Meier and Log rank were used for disease free survival (DFS) analysis.Results385 pts with a diagnosis of CM were analyzed. Median follow-up 45.2 months (IQR: 15.66-91.77). Median age: 52 years (IQR 42-65). SLN+: 47/384 (12.2%). Evaluated prognostic factors: Breslow (Br) 1.5 mm md (IQR 1-2.67), ulceration + 94/385 (24.4%), LVI + 32/144 (22.2%). Relapse 86/367 (23.4%). In the univariate analysis we found association between relapse and the following factors: LVI + (OR: 2.97, p = 0.0125), SLN + (OR: 3.97, p ConclusionsIn our retrospective series, after a long period of follow-up, the presence of LVI as an independent factor was associated with relapse and DFS. Within CM pts the best candidate for adjuvant therapy is yet to be defined, LVI + as a prognostic factor should be validated in prospective trials in this scenario.