Critical appraisal:Pawlik TM, Ross MI, Prieto VG, Ballo MT, Johnson MM, Mansfield PF, et al 2006

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Critical Appraisal

Article being appraised

Pawlik TM, Ross MI, Prieto VG, Ballo MT, Johnson MM, Mansfield PF, et al. Assessment of the role of sentinel lymph node biopsy for primary cutaneous desmoplastic melanoma. Cancer 2006 Feb 15;106(4):900-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16411225.


Applicable clinical question

Key Facts

Study Design

cohort study

Study aims:

1. To define the incidence of DM and evaluate the results of SLNB in patients with DM
2. To analyse the effect of DM histologic subtype (pure vs. mixed) on the incidence of positive SLNs at the time of selective lymphadenectomy

Number of Patients:

1850

Non DM: n=1785

Mixed DM: n=19

Pure DM: n=46
Reported outcome(s):

SLN Status
Characteristics Affecting Disease-Free Survival Rates
3-year acturial disease free survival

Results of outcome(s):

Univariate Analysis of Characteristics Affecting Disease-Free Survival Rates of 65 Patients with DM
- SLN pathologic status 0.02
- Radiation therapy: 0.18*

  • Note that 20.0% of patients with DM (mixed DM, 5 of 19 [26.3%] vs. pure DM, 8 of 46 [17.4%]; P=0.41) received radiotherapy.



3-year acturial disease free survival
- Pure DM: 100%
- Non-DM: 90.5%
- Mixed DM: 78.2% (P=0.004 compared with patients with pure DM).

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

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
Not comparable but adjusted analysis used
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
Pawlik TM, Ross MI, Prieto VG, Ballo MT, Johnson MM, Mansfield PF, et al. Assessment of the role of sentinel lymph node biopsy for primary cutaneous desmoplastic melanoma. Cancer 2006 Feb 15;106(4):900-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16411225.
Assigned to
User:Meghna.kakani
Topic area
Guidelines:Melanoma
Clinical question
Form
Form:Critical appraisal


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