Critical appraisal:Maurichi A, Miceli R, Camerini T, Contiero P, Patuzzo R, Tragni G, et al 2010 3

Critical Appraisal

Article being appraised

Maurichi A, Miceli R, Camerini T, Contiero P, Patuzzo R, Tragni G, et al. Pure desmoplastic melanoma: a melanoma with distinctive clinical behavior. Ann Surg 2010 Dec;252(6):1052-7 Available from: http://www.ncbi.nlm.nih.gov/pubmed/21107116.

Applicable clinical question

• What is the role of sentinel node biopsy for desmoplastic neurotropic melanomas?

Key Facts

Study Design

cohort study

Study aims:

To identify clinical and therapeutic determinants of prognosis in desmoplastic melanoma subtypes, and in particular, to determine whether wider surgical treatment (2 vs. 1 cm) influenced survival in pure desmoplastic melanoma versus mixed desmoplastic melanoma cases, even when lesion were thin (≤2 mm).

Number of Patients:

242

242 patients with DM.

118 were pure DM and 124 were mixed DM.

49 pDM underwent SLNB and 51 mDM underwent SLNB.

Reported outcome(s):

rate of sentinel node metastasis

Results of outcome(s):

pDM = 4/111 had positive sentinel node mets (3.6%); 7 others not assessed
mDM = 17/118 had positive sentinel node mets (14.4%); 6 others not assessed

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

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

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Risk of bias assessment: cohort study

Subject selection

"New technology" group

Highly selected or not described

Comparison group

Highly selected or not described

Comparability of groups on demographic characteristics and clinical features

Comparable

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

Size of effect

5	Reason for decision: Please replace this text and briefly describe the reasons for your rating

Relevance of evidence

2	Additional comments: Please replace this text and briefly describe the reasons for your rating

Result of appraisal

Included

Completed by

Cecilia Taing

This appraisal has been completed.

Article

Maurichi A, Miceli R, Camerini T, Contiero P, Patuzzo R, Tragni G, et al. Pure desmoplastic melanoma: a melanoma with distinctive clinical behavior. Ann Surg 2010 Dec;252(6):1052-7 Available from: http://www.ncbi.nlm.nih.gov/pubmed/21107116.

Assigned to

User:Cecilia.taing

Topic area

Guidelines:Melanoma

Clinical question

• What is the role of sentinel node biopsy for desmoplastic neurotropic melanomas?

Form

Form:Critical appraisal

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