Background: The assessment of the sentinel lymph node is a cornerstone of melanoma staging. However, ~80% of sentinel lymph node biopsies (SLNB) are negative and nontherapeutic, and patients are unnecessarily exposed to surgery-related complications. Here, we gauged the potential of the Merlin assay to reduce SLNB-associated complications. The Merlin assay uses clinicopathologic variables and tumor gene expression profiling to identify low-risk patients who may forgo SLNB.
Methods: We utilized the Merlin test development cohort to determine SLNB complication rates for procedures performed between 2004 and 2018 at Mayo Clinic. Complications evaluated were lymphedema, seroma, infection/cellulitis, hematoma, and wound dehiscence. Patients who underwent a completion lymph node dissection were excluded.
Results: A total of 558 patients were included. The overall 90-day complication rate specific to SLNB (1 year for lymphedema) was 17.4%. The most common complications were seroma (9.3%), infection/cellulitis (4.8%), and lymphedema (4.3%). All three were more common in patients with a lower extremity primary tumor location versus other locations. With Merlin test results applied, SLNB-related complications would have decreased by 59%.
Conclusion: SLNB is a safe procedure but carries a significant complication rate. Merlin testing might reduce the need for SLNB and its associated complications.
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http://dx.doi.org/10.1111/ijd.16056 | DOI Listing |
World J Surg Oncol
January 2025
Institute of Oncology, Tel Aviv Sourasky Medical Center, Weizmann St 6, Tel Aviv, Israel.
Background: De-intensification of anti-cancer therapy without significantly affecting outcomes is an important goal. Omission of axillary surgery or breast radiation is considered a reasonable option in elderly patients with early-stage breast cancer and good prognostic factors. Data on avoidance of both axillary surgery and radiation therapy (RT) is scarce and inconclusive.
View Article and Find Full Text PDFBiomark Res
January 2025
Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, 361003, P.R. China.
Background: Disease progression within 24 months (POD24) significantly impacts overall survival (OS) in patients with follicular lymphoma (FL). This study aimed to develop a robust predictive model, FLIPI-C, using a machine learning approach to identify FL patients at high risk of POD24.
Methods: A cohort of 1,938 FL patients (FL1-3a) from seventeen centers nationwide in China was randomly divided into training and internal validation sets (2:1 ratio).
World J Surg Oncol
January 2025
Summit Medical Group, Bend, OR, USA.
Background: National Comprehensive Cancer Network guidelines recommend sentinel lymph node biopsy (SLNB) for patients with > 10% risk of positivity, consider SLNB with 5-10% risk, and foregoing with < 5% risk. The integrated 31-gene expression profile (i31-GEP) algorithm combines the 31-GEP with clinicopathologic variables, estimating SLN positivity risk.
Methods: The i31-GEP SLNB risk prediction accuracy was assessed in patients with T1-T2 tumors enrolled in the prospective, multicenter DECIDE study (n = 322).
Sci Rep
January 2025
Department of Medical Pathology, Ege University Faculty of Medicine, Ege University Hospital, Bornova, İzmir, Turkey.
This study aimed to evaluate the diagnostic accuracy of ultrasonography in assessing the response of clipped axillary lymph nodes to neoadjuvant chemotherapy. Between February 2022 and September 2023, 43 patients who underwent axillary lymph node marking for targeted axillary dissection were retrospectively analyzed. Ultrasonography parameters such as the number, size, shape, cortical thickness, hilum status, and treatment response of the clipped lymph node were assessed.
View Article and Find Full Text PDFCurr Oncol Rep
January 2025
Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Purpose Of The Review: This narrative review aims to provide an overview of recently completed randomized trials and expert consensus recommendations, and their implications for clinical practice and future trial design in patients with de-novo esophagogastric oligometastatic disease (OMD).
Recent Findings: The IKF-575/RENAISSANCE phase III trial showed no significant overall survival difference between systemic therapy alone and systemic therapy combined with local therapy for patients with gastric or gastroesophageal junction cancer and de-novo OMD, except for patients with retroperitoneal lymph node metastases only. The ESO-Shanghai 13 phase II trial demonstrated superiority of adding local therapy to systemic therapy for progression-free and overall survival in oligometastatic esophageal squamous cell carcinoma.
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