The following is a summary of “Histopathologic regression in patients with primary cutaneous melanoma undergoing sentinel lymph node biopsy is associated with favorable survival and, after metastasis, with improved progression-free survival on immune checkpoint inhibitor therapy: A single-institutional cohort study,” published in the April 2024 issue of Dermatology by Wagner, et al.
Histopathologic regression of cutaneous melanoma is commonly regarded as a favorable prognostic factor, yet its practical significance in clinical settings remains a topic of debate. For a study, researchers sought to explore the prognostic relevance of regression in patients with primary cutaneous melanoma undergoing sentinel lymph node (SLN) biopsy and to evaluate its implications in patients progressing to an unresectable stage necessitating systemic therapy.
A retrospective analysis was conducted on patients newly diagnosed with melanoma who underwent SLN biopsy between 2010 and 2015, with available data on histopathologic regression (n = 1,179). Survival outcomes and correlations between clinical variables and SLN status were examined.
Patients with regressive melanoma exhibited favorable outcomes in terms of relapse-free (hazard ratio [HR], 0.52; P = .00013), distant metastasis–free (HR, 0.56; P = .0020), and melanoma-specific survival (HR, 0.35; P = .00053). Regression was associated with a negative SLN (odds ratio, 0.48; P = .0077). Among patients progressing to an unresectable stage, regression was linked to improved progression-free survival with immune checkpoint inhibition (HR, 0.43; P = .031) but not with targeted therapy (HR, 1.14; P = .73) or chemotherapy (HR, 3.65; P = .0095).
Histopathologic regression of cutaneous melanoma was linked to better prognosis in patients eligible for SLN biopsy and those with unresectable disease receiving systemic therapy with immune checkpoint inhibitors.