Sentinel lymph node biopsy versus observation in high-risk cutaneous squamous cell carcinoma in immunosuppressed and immunocompetent patients : An inverse probability of treatment weighting study
Tejera-Vaquerizo, Antonio (Hospital San Juan de Dios (Córdoba))
Gómez-Tomás, Álvaro (Hospital Universitari Vall d'Hebron)
Jaka, Ane (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Toll Abelló, Agustí (Hospital Clínic i Provincial de Barcelona)
del Río, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrandiz-Pulido, Carla (Universitat Autònoma de Barcelona. Departament de Medicina)
Fuente González, María Josefa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Carrasco Lopez, Cristian (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Almazán-Fernández, Francisco M. (Hospital Universitario San Cecilio (Granada))
Toledo-Pastrana, Tomás (Hospital Quirón Salud Infanta Luisa)
Ferrer-Fuertes, Ada (Hospital Clínic i Provincial de Barcelona)
Ribero, Simone (University of Turin, Italy)
Avallone, Gianluca (University of Turin, Italy)
Cañueto, Javier (Complejo Asistencial Universitario de Salamanca)
Santos-Juanes, Jorge (Hospital Universitario Central de Asturias)
Sanmartín, Onofre (Instituto Valenciano de Oncología (IVO))

Fecha:	2024
Resumen:	Background: The survival benefit of sentinel lymph node biopsy (SLNB) in immunocompetent and immunosuppressed patients with high-risk cutaneous squamous cell carcinoma (cSCC) has not been established. Objective: To determine whether SLNB improves disease-specific survival (DSS) in high-risk cSCC. Secondary objectives were to analyse disease-free survival, nodal recurrence-free survival and overall survival (OS). Methods: Multicentre, retrospective, observational cohort study comparing survival outcomes in immunosuppressed and immunocompetent patients treated with SLNB or watchful waiting. Inverse probability of treatment weighting was used to adjust for possible confounding effects. Results: We studied 638 tumours in immunocompetent patients (SLNB n = 42, observation n = 596) and 173 tumours in immunosuppressed patients (SLNB n = 28, observation n = 145). Overall, SLNB was positive in 15. 7% of tumours. SLNB was associated with a reduced risk of nodal recurrence (NR) (hazard ratio [HR], 0. 05 [95% CI, 0. 01-0. 43]; p = 0. 006), disease specific mortality (HR, 0. 17 [95% CI, 0. 04-0. 72]; p = 0. 016) and all-cause mortality (HR, 0. 33 [95% CI, 0. 15-0. 71]; p = 0. 004) only in immunocompetent patients. Conclusions: SLNB was associated with improvements in NR, DSS and OS in immunocompetent but not in immunosuppressed patients with high-risk cSCC.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió acceptada per publicar
Publicado en:	Journal of the European Academy of Dermatology and Venereology, Vol. 38, Num. 8 (August 2024) , p. 1588-1598, ISSN 1468-3083

DOI: 10.1111/jdv.20051

24 p, 553.2 KB

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