tailieunhanh - báo cáo khoa học: "Thick primary melanoma has a heterogeneous tumor biology: an institutional series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Thick primary melanoma has a heterogeneous tumor biology: an institutional series | Meguerditchian et al. World Journal of Surgical Oncology 2011 9 40 http content 9 1 40 5 t WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Open Access Thick primary melanoma has a heterogeneous tumor biology an institutional series Ari-Nareg Meguerditchian1 3 Kobby Asubonteng23 Calvin Young33 Bethany Lema33 Gregory Wilding23 and John M Kane III43 Abstract Background Thick melanomas TM 4 mm have a high risk for nodal and distant metastases. Optimal surgical management prognostic significance of sentinel node biopsy SLNB and benefits of interferon IFN for these patients are unclear. As a continuum of increasing tumor thickness is placed into a single TM group differences in biologic and clinical behavior may be lost. The purpose of this study was to better characterize the diverse biology in TM including the value of increasing thickness and nodal status information potentially identifying high risk TM subgroups that may warrant more aggressive treatment follow up. Methods 155 consecutive TM patients treated at a single institution between 1971 and 2007 were retrospectively reviewed. Patient disease and treatment features were analyzed with respect to disease-free DFS and overall survival OS . Results Median patient age was 66 years and 68 of patients were men. The trunk was the most common TM location 35 followed by the head and neck 29 and lower extremities 20 . Median thickness was 6 mm and 61 were ulcerated. 6 patients had stage IV disease 12 had clinical nodal metastases. Clinically negative lymph node basins were treated by observation 22 patients - elective lymph node dissection ELND 24 patients - or SLNB 91 patients - 67 . 75 of ELND s and 53 of SLNB s were positive. Completion node dissection was performed in 38 SLNB patients and 22 had additional positive nodes. 17 of the study patients received IFN. At median follow up of 26 months 5 year DFS and OS were 42 and . For SLNB positive vs negative median DFS were 22 vs 111 months p