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 journalArticlepeer-review

13 Scopus citations


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
Issue number5
StatePublished - May 2014


  • Melanoma
  • Sentinel lymph node biopsy
  • Thick

ASJC Scopus subject areas

  • Surgery


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