Stratifying SLN Incidence in Intermediate Thickness Melanoma Patients

Overview

Journal Am J Surg

Specialty General Surgery

Date 2018 Mar 6

PMID 29502857

Citations 12

Authors

James M Chang

Heidi E Kosiorek

Amylou C Dueck

Stanley P L Leong

John T Vetto

Richard L White

Eli Avisar

Vernon K Sondak

Jane L Messina

Jonathan S Zager

Carlos Garberoglio

Mohammed Kashani-Sabet

Barbara A Pockaj

Affiliations

Soon will be listed here.

Abstract

Background: Guidelines for melanoma recommend sentinel lymph node biopsy (SLNB) in patients with melanomas ≥1 mm thickness. Recent single institution studies have found tumors <1.5 mm a low-risk group for positive SLNB.

Methods: A retrospective review of the Sentinel Lymph Node Working Group multicenter database identified patients with intermediate thickness melanoma (1.01-4.00 mm) who had SLNB, and assessed predictors for positive SLNB.

Results: 3460 patients were analyzed, 584 (17%) had a positive SLNB. Univariate factors associated with a positive SLNB included age <60 (p < .001), tumor on the trunk/lower extremity (p < .001), Breslow depth ≥2 mm (p < .001), ulceration (p < .001), mitotic rate ≥1/mm (p = .01), and microsatellitosis (p < .001). Multivariate analysis revealed age, location, and Breslow depth as significant predictors. Patients ≥75 with lesions 1.01-1.49 mm on the head/neck/upper extremity and 1.5-1.99 mm without high-risk features had <5% risk of SLN positivity.

Conclusions: Intermediate thickness melanoma has significant heterogeneity of SLNB positivity. Low-risk subgroups can be found among older patients in the absence of high-risk features.

Citing Articles

Invasive Cutaneous Melanoma: Evaluating the Prognostic Significance of Some Parameters Associated with Lymph Node Metastases.

Vita O, Jurescu A, Vaduva A, Cornea R, Cornianu M, Taban S Medicina (Kaunas). 2023; 59(7).

PMID: 37512052 PMC: 10385614. DOI: 10.3390/medicina59071241.

The Evolution of the Sentinel Node Biopsy in Melanoma.

Allard-Coutu A, Dobson V, Schmitz E, Shah H, Nessim C Life (Basel). 2023; 13(2).

PMID: 36836846 PMC: 9966203. DOI: 10.3390/life13020489.

Redesigning Sentinel Lymph Node Biopsy Guidelines in Melanoma Cases.

Stetkevich S, Simman R Eplasty. 2023; 23:e8.

PMID: 36817365 PMC: 9912052.

Predictors of Nodal Metastasis in Cutaneous Head and Neck Cancers.

Han A, St John M Curr Oncol Rep. 2022; 24(9):1145-1152.

PMID: 35394247 PMC: 9468084. DOI: 10.1007/s11912-022-01249-5.

Surgery for Cutaneous Squamous Cell Carcinoma and its Limits in Advanced Disease.

Moreno-Ramirez D, Silva-Claveria F, Fernandez-Orland A, Eiris N, Ruiz de Casas A, Ferrandiz L Dermatol Pract Concept. 2021; 11(Suppl 2):e2021167S.

PMID: 34877075 PMC: 8609953. DOI: 10.5826/dpc.11S2a167S.

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