Critical appraisal:Broer PN, Walker ME, Goldberg C, Buonocore S, Braddock DT, Lazova R, et al 2013

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Critical Appraisal

Article being appraised

Broer PN, Walker ME, Goldberg C, Buonocore S, Braddock DT, Lazova R, et al. Desmoplastic melanoma: a 12-year experience with sentinel lymph node biopsy. Eur J Surg Oncol 2013 Jul;39(7):681-5 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23522951.


Applicable clinical question

Key Facts

Study Design

cohort study

Study aims:

To review the incidence of nodal metastasis in our patients with Desmoplastic Melanoma (DM) to better define guidelines regarding the performance of sentinel lymph node biopsy (SLNB) in this specific melanoma subtype

Number of Patients:

24

24 patients with DM,
22 of which underwent SLNB
Reported outcome(s):

micro-metastasis
local recurrence
in-transit recurrence

Results of outcome(s):

Twenty-two patients from the DM group had SLNB

- Four patients (18%) were diagnosed with micro-metastasis
- Two patients (9%) developed local recurrence,
- Two patients (9%) developed in-transit recurrence,
- Six patients (27%) showed distant metastases (three patients were pure DM and three patients showed mixed morphology)
- Also note that patients with mixed DM had a higher rate of nodal metastasis (25%) vs those with pure DM (14%).

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-1

Risk of bias
High risk of bias Comments: Please replace this text and include any additional comments in regards to your risk of bias rating

Risk of bias assessment: cohort study

Subject selection
"New technology" group
Highly selected or not described
Comparison group
Selected group
Comparability of groups on demographic characteristics and clinical features
Not comparable and not adjusted for differences
Measurement of outcomes
Outcome measures blind to technology used
No, but objective measures used
Same method of measurement used across comparison groups
Yes
Completeness of follow-up
Was follow-up complete and were all patients included in the analysis?
Yes (follow-up >95%) or survival analysis using all patients
Result of appraisal

Jutta's tick icon.png Included




Completed by

Meghna Kakani


Jutta's tick icon.png This appraisal has been completed.


Article
Broer PN, Walker ME, Goldberg C, Buonocore S, Braddock DT, Lazova R, et al. Desmoplastic melanoma: a 12-year experience with sentinel lymph node biopsy. Eur J Surg Oncol 2013 Jul;39(7):681-5 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23522951.
Assigned to
User:Meghna.kakani
Topic area
Guidelines:Melanoma
Clinical question
Form
Form:Critical appraisal


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