1. Assessment of Frailty Can Guide Decision Making for Utilization of Sentinel Lymph Node Biopsy in Patients with Thick Melanoma
- Author
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Amy Tin, Mary Sue Brady, Jessica Flynn, Avinash Sharma, Edmund K. Bartlett, Armin Shahrokni, Danielle M. Bello, Charlotte E. Ariyan, Katherine S. Panageas, and Daniel G. Coit
- Subjects
Oncology ,medicine.medical_specialty ,Skin Neoplasms ,Decision Making ,Sentinel lymph node ,030230 surgery ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Biopsy ,Humans ,Medicine ,Stage (cooking) ,Melanoma ,Retrospective Studies ,Frailty ,medicine.diagnostic_test ,Sentinel Lymph Node Biopsy ,business.industry ,Proportional hazards model ,Hazard ratio ,Prognosis ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,Cutaneous melanoma ,Surgery ,Sentinel Lymph Node ,business - Abstract
Sentinel lymph node biopsy (SLNB) is often omitted in selected patients with advanced primary melanoma, although the justification/criteria for omission have been debated. We sought to determine whether assessment of frailty could serve as an objective marker to guide selection for SLNB in patients with advanced primary melanoma. Patients presenting with clinical stage IIC (ulcerated, > 4 mm Breslow thickness) cutaneous melanoma from January 1999 through June 2019 were included. Frailty was assessed using the Memorial Sloan Kettering Frailty Index (MSK FI), a composite score of functional status and medical comorbidities. Five-year melanoma-specific survival (MSS) and overall survival (OS) were estimated using Cox regression, and predictors of OS were identified using competing risk models. MSS did not differ between patients who did (n = 451) or did not undergo SLNB (n = 179) [63.2% vs. 65.0%, p = 0.14]; however, omission of SLNB was associated with decreased 5-year OS (29% vs. 44%, p
- Published
- 2021
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