Clinical impact of sentinel lymph node biopsy in patients with thick (>4 mm) melanomas

Ian White, Jeanine Fortino, Brendan Curti, John Vetto

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Background: The role of sentinel lymph node status (SLNS) in thick melanoma is evolving. The purpose of this study was to determine the prognostic value of SLNS in thick melanoma. Methods: A retrospective analysis of 120 prospectively collected clinically node-negative thick melanomas over 5 years was performed. Patient (age/sex) and tumor (thickness, ulceration, SLNS, mitoses, metastases, and recurrence) features were collected. Multivariate analysis was performed using Cox proportional hazard model. Results: Factors predictive of positive SLN included male sex, ulceration, and high mitoses. Factors associated with positive SLN had higher local-regional recurrence and metastases than negative SLN. SLNS and tumor thickness impacted 5-year disease-free survival (DFS) and overall survival (OS). Positive SLN, ulceration, age, and mitoses were independent predictors of DFS/OS. Conclusions: Nonulcerated/lower mitoses thick melanomas had lower positive SLN rates. Positive SLN develop recurrence and metastases and have worse OS/DFS. SLNS is an important prognosticator for OS/DFS. Sentinel lymph node biopsy delineates prognostic groups in thick melanomas and can impact management.

    Original languageEnglish (US)
    Pages (from-to)702-707
    Number of pages6
    JournalAmerican Journal of Surgery
    Volume207
    Issue number5
    DOIs
    StatePublished - 2014

    Fingerprint

    Sentinel Lymph Node Biopsy
    Melanoma
    Mitosis
    Disease-Free Survival
    Survival
    Neoplasm Metastasis
    Recurrence
    Proportional Hazards Models
    Neoplasms
    Multivariate Analysis
    Sentinel Lymph Node

    Keywords

    • Melanoma
    • Sentinel lymph node biopsy
    • Thick

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Clinical impact of sentinel lymph node biopsy in patients with thick (>4 mm) melanomas. / White, Ian; Fortino, Jeanine; Curti, Brendan; Vetto, John.

    In: American Journal of Surgery, Vol. 207, No. 5, 2014, p. 702-707.

    Research output: Contribution to journalArticle

    White, Ian ; Fortino, Jeanine ; Curti, Brendan ; Vetto, John. / Clinical impact of sentinel lymph node biopsy in patients with thick (>4 mm) melanomas. In: American Journal of Surgery. 2014 ; Vol. 207, No. 5. pp. 702-707.
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    abstract = "Background: The role of sentinel lymph node status (SLNS) in thick melanoma is evolving. The purpose of this study was to determine the prognostic value of SLNS in thick melanoma. Methods: A retrospective analysis of 120 prospectively collected clinically node-negative thick melanomas over 5 years was performed. Patient (age/sex) and tumor (thickness, ulceration, SLNS, mitoses, metastases, and recurrence) features were collected. Multivariate analysis was performed using Cox proportional hazard model. Results: Factors predictive of positive SLN included male sex, ulceration, and high mitoses. Factors associated with positive SLN had higher local-regional recurrence and metastases than negative SLN. SLNS and tumor thickness impacted 5-year disease-free survival (DFS) and overall survival (OS). Positive SLN, ulceration, age, and mitoses were independent predictors of DFS/OS. Conclusions: Nonulcerated/lower mitoses thick melanomas had lower positive SLN rates. Positive SLN develop recurrence and metastases and have worse OS/DFS. SLNS is an important prognosticator for OS/DFS. Sentinel lymph node biopsy delineates prognostic groups in thick melanomas and can impact management.",
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    N2 - Background: The role of sentinel lymph node status (SLNS) in thick melanoma is evolving. The purpose of this study was to determine the prognostic value of SLNS in thick melanoma. Methods: A retrospective analysis of 120 prospectively collected clinically node-negative thick melanomas over 5 years was performed. Patient (age/sex) and tumor (thickness, ulceration, SLNS, mitoses, metastases, and recurrence) features were collected. Multivariate analysis was performed using Cox proportional hazard model. Results: Factors predictive of positive SLN included male sex, ulceration, and high mitoses. Factors associated with positive SLN had higher local-regional recurrence and metastases than negative SLN. SLNS and tumor thickness impacted 5-year disease-free survival (DFS) and overall survival (OS). Positive SLN, ulceration, age, and mitoses were independent predictors of DFS/OS. Conclusions: Nonulcerated/lower mitoses thick melanomas had lower positive SLN rates. Positive SLN develop recurrence and metastases and have worse OS/DFS. SLNS is an important prognosticator for OS/DFS. Sentinel lymph node biopsy delineates prognostic groups in thick melanomas and can impact management.

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