General Poster Session
AB149. SOH21AS108. The impact of wide local excision and sentinel node biopsy on outcomes of patients with melanoma over age 70
Kirsten Carpenter1,2, Stephanie Bollard1,2,3, Christine Quinlan1, Shirley Potter1,2, Robert Caulfield1, Richard Hanson1, Dylan Murray1, Kevin Cronin1
1Department of Plastic & Reconstructive Surgery, Mater Misericordiae University Hospital, School of Medicine, Dublin, Ireland; 2University College Dublin, School of Medicine, Dublin, Ireland; 3University College Dublin, Charles Institute of Dermatology, Dublin, Ireland
Background: The incidence of melanoma is increasing in the elderly population, in whom prevalent comorbidities must be considered perioperatively. Despite developments in adjuvant therapy, wide local excision (WLE) +/− sentinel lymph node biopsy (SLNB) remains the cornerstone of treatment. This study aims to determine how age and associated comorbid factors influence surgical decision-making and subsequent outcomes for melanoma patients over the age of 70 years.
Methods: Data was collected retrospectively for all melanoma patients over the age of 70 treated at a single tertiary referral centre over 10 years. Demographics, comorbidities, diagnosis, surgical management details, disease-free (DFS) and overall survival (OS) were tabulated. The impact of age and comorbidities were analysed.
Results: A total of 107 patients met inclusion criteria. Median age was 79.33 (range, 70–96) years, and median Breslow Thickness was 1.45 (range, 0.02–22) mm. Excisional biopsy only was performed in 15% (n=16), with 85% (n=91) progressing to WLE. Patients who underwent WLE displayed increased DFS (P=0.003), with no impact on OS (P=0.716), and were significantly younger than those who only had excisional biopsy (P=0.003). Of those eligible for SLNB (n=41), 53.7% (n=22) underwent the procedure. SLNB had no significant impact on DFS (P=0.633) or OS (P=0.222).
Conclusions: In the elderly melanoma patient cohort, WLE resulted in improved DFS, but had no effect on OS. Patients who are suitable surgical candidates should be offered WLE where possible, in an effort to reduce morbidity from recurrent disease.
Keywords: Aged; 70 and over; comorbidity; melanoma; mortality; sentinel lymph node biopsy (SLNB); wide local excision (WLE)
Acknowledgments
Funding: None.
Conflicts of Interest: The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
doi: 10.21037/map-21-ab149
Cite this abstract as: Carpenter K, Bollard S, Quinlan C, Potter S, Caulfield R, Hanson R, Murray D, Cronin K. SOH21AS108. The impact of wide local excision and sentinel node biopsy on outcomes of patients with melanoma over age 70. Mesentery Peritoneum 2021;5:AB149.
