Association of sentinel lymph node biopsy with survival for head and neck melanoma: survival analysis using the SEER database

Steven M Sperry; Mary E Charlton; Nitin A Pagedar

doi:10.1001/jamaoto.2014.2530

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Association of sentinel lymph node biopsy with survival for head and neck melanoma: survival analysis using the SEER database

Journal article

Open access

Peer reviewed

Association of sentinel lymph node biopsy with survival for head and neck melanoma: survival analysis using the SEER database

Steven M Sperry, Mary E Charlton and Nitin A Pagedar

JAMA otolaryngology-- head & neck surgery, Vol.140(12), pp.1101-1109

12/2014

DOI: 10.1001/jamaoto.2014.2530

PMCID: PMC4294459

PMID: 25321889

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Abstract

Sentinel lymph node biopsy (SLNB) provides prognostic information for melanoma; however, a survival benefit has not been demonstrated. To assess the association of SLNB with survival for melanoma arising in head and neck subsites (HNM). Propensity score-matched retrospective cohort study using the Surveillance Epidemiology and End Results (SEER) database to compare US patients with HNM meeting current recommendations for SLNB, treated from 2004 to 2011 with either (1) SLNB with or without neck dissection, or (2) no SLNB or neck dissection. SLNB with or without neck dissection. Disease-specific survival (DSS) estimates based on the Kaplan-Meier method, and Cox proportional hazards modeling to compare survival outcomes between matched pair cohorts. A total of 7266 patients with HNM meeting study criteria were identified from the SEER database. Matching of treatment cohorts was performed using propensity scores modeled on 10 covariates known to be associated with SLNB treatment or melanoma survival. Cohorts were stratified by tumor thickness (thin, >0.75-1.00 mm Breslow thickness; intermediate, >1.00-4.00 mm; and thick, >4.00 mm) and exactly matched within 5 age categories. In the intermediate-thickness cohort, 2808 patients with HNM were matched and balanced by propensity score for SLNB treatment; the 5-year DSS estimate for those treated by SLNB was 89% vs 88% for nodal observation (log-rank P = .30). The hazard ratio for melanoma-specific death was 0.87 for those undergoing SLNB (95% CI, 0.66-1.14; P = .31). In each of the other cohorts analyzed, including those with thin and thick melanomas, and cohorts with melanoma overall, no significant difference in DSS was demonstrated. This SEER cohort analysis demonstrates no significant association between SLNB and improved disease-specific survival for patients with HNM.

United States - epidemiology

SEER Program

Humans

Middle Aged

Male

Melanoma - pathology

Head and Neck Neoplasms - pathology

Young Adult

Adolescent

Survival Analysis

Aged, 80 and over

Adult

Female

Aged

Retrospective Studies

Sentinel Lymph Node Biopsy

Head and Neck Neoplasms - mortality

Melanoma - surgery

Head and Neck Neoplasms - surgery

Melanoma - mortality

Neck Dissection

Details

Title: Subtitle: Association of sentinel lymph node biopsy with survival for head and neck melanoma: survival analysis using the SEER database
Creators: Steven M Sperry - Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
Mary E Charlton - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Nitin A Pagedar - Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City
Resource Type: Journal article
Publication Details: JAMA otolaryngology-- head & neck surgery, Vol.140(12), pp.1101-1109
DOI: 10.1001/jamaoto.2014.2530
PMID: 25321889
PMCID: PMC4294459
NLM abbreviation: JAMA Otolaryngol Head Neck Surg
ISSN: 2168-6181
eISSN: 2168-619X
Publisher: United States
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 12/2014
Academic Unit: Health Management and Policy; Epidemiology; Otolaryngology
Record Identifier: 9983995013802771

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