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Annals of Surgical Oncology

, Volume 24, Issue 8, pp 2089–2094 | Cite as

The Impact of Smoking on Sentinel Node Metastasis of Primary Cutaneous Melanoma

  • Maris S. Jones
  • Peter C. Jones
  • Stacey L. Stern
  • David Elashoff
  • Dave S. B. Hoon
  • John Thompson
  • Nicola Mozzillo
  • Omgo E. Nieweg
  • Dirk Noyes
  • Harald J. Hoekstra
  • Jonathan S. Zager
  • Daniel F. Roses
  • Alessandro Testori
  • Brendon J. Coventry
  • Mark B. Smithers
  • Robert Andtbacka
  • Doreen Agnese
  • Erwin Schultz
  • Eddy C. Hsueh
  • Mark Kelley
  • Schlomo Schneebaum
  • Lisa Jacobs
  • Tawnya Bowles
  • Mohammed Kashani-Sabet
  • Douglas Johnson
  • Mark B. Faries
Melanomas

Abstract

Background

Although a well-established causative relationship exists between smoking and several epithelial cancers, the association of smoking with metastatic progression in melanoma is not well studied. We hypothesized that smokers would be at increased risk for melanoma metastasis as assessed by sentinel lymph node (SLN) biopsy.

Methods

Data from the first international Multicenter Selective Lymphadenectomy Trial (MSLT-I) and the screening-phase of the second trial (MSLT-II) were analyzed to determine the association of smoking with clinicopathologic variables and SLN metastasis.

Results

Current smoking was strongly associated with SLN metastasis (p = 0.004), even after adjusting for other predictors of metastasis. Among 4231 patients (1025 in MSLT-I and 3206 in MSLT-II), current or former smoking was also independently associated with ulceration (p < 0.001 and p < 0.001, respectively). Compared with current smoking, never smoking was independently associated with decreased Breslow thickness in multivariate analysis (p = 0.002) and with a 0.25 mm predicted decrease in thickness.

Conclusion

The direct correlation between current smoking and SLN metastasis of primary cutaneous melanoma was independent of its correlation with tumor thickness and ulceration. Smoking cessation should be strongly encouraged among patients with or at risk for melanoma.

Keywords

Melanoma Sentinel Lymph Node Sentinel Lymph Node Biopsy Sentinel Lymph Node Positivity Sentinel Lymph Node Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This study was supported by Grants CA189163 and CA29605 from the National Cancer Institute, and by funding from the Amyx Foundation, Inc. Boise, ID, USA; the Borstein Family Foundation, Los Angeles, CA, USA; Dr Miriam and Sheldon G. Adelson Medical Research Foundation, Boston, MA, USA; and the John Wayne Cancer Institute Auxiliary, Santa Monica, CA, USA. Dr Maris S. Jones is the Harold McAlister Charitable Foundation Fellow. The content of this report is solely the responsibility of the authors and does not necessarily represent the official view of the National Cancer Institute or the National Institutes of Health.

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Maris S. Jones
    • 1
  • Peter C. Jones
    • 1
    • 2
  • Stacey L. Stern
    • 3
  • David Elashoff
    • 4
  • Dave S. B. Hoon
    • 2
  • John Thompson
    • 5
  • Nicola Mozzillo
    • 6
  • Omgo E. Nieweg
    • 5
  • Dirk Noyes
    • 7
  • Harald J. Hoekstra
    • 8
  • Jonathan S. Zager
    • 9
  • Daniel F. Roses
    • 10
  • Alessandro Testori
    • 11
  • Brendon J. Coventry
    • 12
  • Mark B. Smithers
    • 13
  • Robert Andtbacka
    • 14
  • Doreen Agnese
    • 15
  • Erwin Schultz
    • 16
  • Eddy C. Hsueh
    • 17
  • Mark Kelley
    • 18
  • Schlomo Schneebaum
    • 19
  • Lisa Jacobs
    • 20
  • Tawnya Bowles
    • 7
  • Mohammed Kashani-Sabet
    • 21
  • Douglas Johnson
    • 18
  • Mark B. Faries
    • 22
  1. 1.Division of Surgical OncologyJohn Wayne Cancer Institute at Providence Saint John’s Health CenterSanta MonicaUSA
  2. 2.Department of Molecular OncologyJohn Wayne Cancer Institute at Providence Saint John’s Health CenterSanta MonicaUSA
  3. 3.Department of BiostatisticsJohn Wayne Cancer Institute at Providence Saint John’s Health CenterSanta MonicaUSA
  4. 4.UCLA Department of BiostatisticsLos AngelesUSA
  5. 5.Melanoma Institute AustraliaSydneyAustralia
  6. 6.Istituto Nazionale dei Tumori NapoliNapoliItaly
  7. 7.IHC Cancer ServicesIntermountain Medical CenterSalt Lake CityUSA
  8. 8.Universitair Medisch Centrum GroningenGroningenThe Netherlands
  9. 9.H. Lee Moffitt Cancer CenterTampaUSA
  10. 10.NYU Langone Medical CenterNew YorkUSA
  11. 11.Istituto Europeo di OncologiaMilanoItaly
  12. 12.Royal Adelaide Hospital Discipline of SurgeryRoyal Adelaide HospitalUniversity of AdelaideAdelaideAustralia
  13. 13.Princess Alexandra HospitalWoolloongabbaAustralia
  14. 14.Huntsman Cancer InstituteSalt Lake CityUSA
  15. 15.Ohio State UniversityColumbusUSA
  16. 16.Nuremberg General Hospital - Paracelsus Medical UniversityNurembergGermany
  17. 17.Saint Louis UniversitySt. LouisUSA
  18. 18.Vanderbilt UniversityNashvilleUSA
  19. 19.Tel-Aviv Sourasky Medical CenterTel-AvivIsrael
  20. 20.Johns Hopkins Medical InstituteBaltimoreUSA
  21. 21.California Pacific Medical CenterSan FranciscoUSA
  22. 22.Department of Melanoma ResearchJohn Wayne Cancer Institute at Providence Saint John’s Health CenterSanta MonicaUSA

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