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    Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy

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    Author
    Adler, NR; Wolfe, R; McArthur, GA; Kelly, JW; Haydon, A; McLean, CA; Mar, VJ
    Date
    2018-05-01
    Source Title
    British Journal of Cancer
    Publisher
    NATURE PUBLISHING GROUP
    University of Melbourne Author/s
    McLean, Catriona; McArthur, Grant
    Affiliation
    Melbourne Medical School
    Florey Department of Neuroscience and Mental Health
    Metadata
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    Document Type
    Journal Article
    Citations
    Adler, N. R., Wolfe, R., McArthur, G. A., Kelly, J. W., Haydon, A., McLean, C. A. & Mar, V. J. (2018). Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy. BRITISH JOURNAL OF CANCER, 118 (10), pp.1289-1295. https://doi.org/10.1038/s41416-018-0088-8.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255139
    DOI
    10.1038/s41416-018-0088-8
    Abstract
    BACKGROUND: A proportion of patients develop recurrence following a tumour-negative sentinel lymph node biopsy (SLNB). This study aimed to explore whether melanoma patients with BRAF or NRAS mutant tumours have an increased risk of developing disease recurrence following a negative SLNB compared to patients with wild-type tumours. METHODS: Prospective cohort study of melanoma patients at three tertiary referral centres in Melbourne, who underwent SLNB. Clinical, pathological and molecular characteristics and recurrence data were prospectively recorded. Multivariate Cox proportional hazards regression models estimated the adjusted hazard ratio (aHR) and corresponding 95% confidence interval (CI) for the association between mutation status and development of recurrence following a negative-SLNB. RESULTS: Overall, 344/477 (72.1%) patients had a negative SLNB. Of these, 54 (15.7%) developed subsequent recurrence. The risk of disease recurrence following a negative SLNB was increased for patients with either a BRAF or NRAS mutant tumour compared to wild-type tumours (aHR 1.92, 95% CI: 1.02-3.60, p = 0.04). CONCLUSION: Melanoma patients with BRAF or NRAS mutant tumours had an increased risk compared to patients with BRAF/NRAS wild-type tumours of developing disease recurrence following a tumour-negative SLNB. The findings also confirm the importance of continued surveillance to monitor for disease recurrence among SLNB-negative patients.

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