Desmoplastic melanoma

Is there a role for sentinel lymph node biopsy?

Dale Han, Jonathan S. Zager, Daohai Yu, Xiuhua Zhao, Brooke Walls, Suroosh S. Marzban, Nikhil G. Rao, Vernon K. Sondak, Jane L. Messina

Research output: Contribution to journalReview article

25 Citations (Scopus)

Abstract

Background: The utility of sentinel lymph node biopsy (SLNB) for desmoplastic melanoma (DM) is debated. We describe a large single-institution experience with SLNB for DM to determine clinicopathologic factors predictive of SLN metastasis. Methods: Retrospective review identified 205 patients with DM who underwent SLNB from 1992 to 2010. Clinicopathologic characteristics were correlated with SLN status and outcome. Results: Median age was 66 years, and 69 % of patients were male. Median Breslow thickness was 3.7 mm. In 128 cases (62 %), histologic subtype data was available; 61 cases (47.7 %) were mixed and 67 cases (52.3 %) were pure DM. A positive SLN was found in 28 cases (13.7 %); 24.6 % of mixed and 9 % of pure DM had SLN metastases. Multivariable analysis demonstrated that after controlling for age, histologic subtype correlated with SLN status [odds ratio: 3.0 for mixed vs pure, 95 % confidence interval: 1.1-8.7; p <.05]. Completion lymph node dissection was performed in 24 of 28 positive SLN patients with 16.7 % of cases having additional nodal disease. After a median follow-up of 6.3 years, 38 patients developed recurrence and 61 patients died. Positive SLN patients had a significantly higher risk of melanoma-related death compared with negative SLN patients (p =.01). Conclusions: The overall risk for SLN metastasis for DM is 13.7 % and is significantly higher for mixed (24.6 %) compared with pure (9.0 %) DM. We believe that these rates are sufficient to justify consideration of SLNB for both histologic variants, especially since detection of SLN disease appears to predict a higher risk for melanoma-related death.

Original languageEnglish (US)
Pages (from-to)2345-2351
Number of pages7
JournalAnnals of surgical oncology
Volume20
Issue number7
DOIs
StatePublished - Jul 1 2013
Externally publishedYes

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Sentinel Lymph Node Biopsy
Melanoma
Neoplasm Metastasis
Lymph Node Excision
Odds Ratio
Confidence Intervals
Recurrence

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Han, D., Zager, J. S., Yu, D., Zhao, X., Walls, B., Marzban, S. S., ... Messina, J. L. (2013). Desmoplastic melanoma: Is there a role for sentinel lymph node biopsy? Annals of surgical oncology, 20(7), 2345-2351. https://doi.org/10.1245/s10434-013-2883-z

Desmoplastic melanoma : Is there a role for sentinel lymph node biopsy? / Han, Dale; Zager, Jonathan S.; Yu, Daohai; Zhao, Xiuhua; Walls, Brooke; Marzban, Suroosh S.; Rao, Nikhil G.; Sondak, Vernon K.; Messina, Jane L.

In: Annals of surgical oncology, Vol. 20, No. 7, 01.07.2013, p. 2345-2351.

Research output: Contribution to journalReview article

Han, D, Zager, JS, Yu, D, Zhao, X, Walls, B, Marzban, SS, Rao, NG, Sondak, VK & Messina, JL 2013, 'Desmoplastic melanoma: Is there a role for sentinel lymph node biopsy?', Annals of surgical oncology, vol. 20, no. 7, pp. 2345-2351. https://doi.org/10.1245/s10434-013-2883-z
Han, Dale ; Zager, Jonathan S. ; Yu, Daohai ; Zhao, Xiuhua ; Walls, Brooke ; Marzban, Suroosh S. ; Rao, Nikhil G. ; Sondak, Vernon K. ; Messina, Jane L. / Desmoplastic melanoma : Is there a role for sentinel lymph node biopsy?. In: Annals of surgical oncology. 2013 ; Vol. 20, No. 7. pp. 2345-2351.
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title = "Desmoplastic melanoma: Is there a role for sentinel lymph node biopsy?",
abstract = "Background: The utility of sentinel lymph node biopsy (SLNB) for desmoplastic melanoma (DM) is debated. We describe a large single-institution experience with SLNB for DM to determine clinicopathologic factors predictive of SLN metastasis. Methods: Retrospective review identified 205 patients with DM who underwent SLNB from 1992 to 2010. Clinicopathologic characteristics were correlated with SLN status and outcome. Results: Median age was 66 years, and 69 {\%} of patients were male. Median Breslow thickness was 3.7 mm. In 128 cases (62 {\%}), histologic subtype data was available; 61 cases (47.7 {\%}) were mixed and 67 cases (52.3 {\%}) were pure DM. A positive SLN was found in 28 cases (13.7 {\%}); 24.6 {\%} of mixed and 9 {\%} of pure DM had SLN metastases. Multivariable analysis demonstrated that after controlling for age, histologic subtype correlated with SLN status [odds ratio: 3.0 for mixed vs pure, 95 {\%} confidence interval: 1.1-8.7; p <.05]. Completion lymph node dissection was performed in 24 of 28 positive SLN patients with 16.7 {\%} of cases having additional nodal disease. After a median follow-up of 6.3 years, 38 patients developed recurrence and 61 patients died. Positive SLN patients had a significantly higher risk of melanoma-related death compared with negative SLN patients (p =.01). Conclusions: The overall risk for SLN metastasis for DM is 13.7 {\%} and is significantly higher for mixed (24.6 {\%}) compared with pure (9.0 {\%}) DM. We believe that these rates are sufficient to justify consideration of SLNB for both histologic variants, especially since detection of SLN disease appears to predict a higher risk for melanoma-related death.",
author = "Dale Han and Zager, {Jonathan S.} and Daohai Yu and Xiuhua Zhao and Brooke Walls and Marzban, {Suroosh S.} and Rao, {Nikhil G.} and Sondak, {Vernon K.} and Messina, {Jane L.}",
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TY - JOUR

T1 - Desmoplastic melanoma

T2 - Is there a role for sentinel lymph node biopsy?

AU - Han, Dale

AU - Zager, Jonathan S.

AU - Yu, Daohai

AU - Zhao, Xiuhua

AU - Walls, Brooke

AU - Marzban, Suroosh S.

AU - Rao, Nikhil G.

AU - Sondak, Vernon K.

AU - Messina, Jane L.

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Background: The utility of sentinel lymph node biopsy (SLNB) for desmoplastic melanoma (DM) is debated. We describe a large single-institution experience with SLNB for DM to determine clinicopathologic factors predictive of SLN metastasis. Methods: Retrospective review identified 205 patients with DM who underwent SLNB from 1992 to 2010. Clinicopathologic characteristics were correlated with SLN status and outcome. Results: Median age was 66 years, and 69 % of patients were male. Median Breslow thickness was 3.7 mm. In 128 cases (62 %), histologic subtype data was available; 61 cases (47.7 %) were mixed and 67 cases (52.3 %) were pure DM. A positive SLN was found in 28 cases (13.7 %); 24.6 % of mixed and 9 % of pure DM had SLN metastases. Multivariable analysis demonstrated that after controlling for age, histologic subtype correlated with SLN status [odds ratio: 3.0 for mixed vs pure, 95 % confidence interval: 1.1-8.7; p <.05]. Completion lymph node dissection was performed in 24 of 28 positive SLN patients with 16.7 % of cases having additional nodal disease. After a median follow-up of 6.3 years, 38 patients developed recurrence and 61 patients died. Positive SLN patients had a significantly higher risk of melanoma-related death compared with negative SLN patients (p =.01). Conclusions: The overall risk for SLN metastasis for DM is 13.7 % and is significantly higher for mixed (24.6 %) compared with pure (9.0 %) DM. We believe that these rates are sufficient to justify consideration of SLNB for both histologic variants, especially since detection of SLN disease appears to predict a higher risk for melanoma-related death.

AB - Background: The utility of sentinel lymph node biopsy (SLNB) for desmoplastic melanoma (DM) is debated. We describe a large single-institution experience with SLNB for DM to determine clinicopathologic factors predictive of SLN metastasis. Methods: Retrospective review identified 205 patients with DM who underwent SLNB from 1992 to 2010. Clinicopathologic characteristics were correlated with SLN status and outcome. Results: Median age was 66 years, and 69 % of patients were male. Median Breslow thickness was 3.7 mm. In 128 cases (62 %), histologic subtype data was available; 61 cases (47.7 %) were mixed and 67 cases (52.3 %) were pure DM. A positive SLN was found in 28 cases (13.7 %); 24.6 % of mixed and 9 % of pure DM had SLN metastases. Multivariable analysis demonstrated that after controlling for age, histologic subtype correlated with SLN status [odds ratio: 3.0 for mixed vs pure, 95 % confidence interval: 1.1-8.7; p <.05]. Completion lymph node dissection was performed in 24 of 28 positive SLN patients with 16.7 % of cases having additional nodal disease. After a median follow-up of 6.3 years, 38 patients developed recurrence and 61 patients died. Positive SLN patients had a significantly higher risk of melanoma-related death compared with negative SLN patients (p =.01). Conclusions: The overall risk for SLN metastasis for DM is 13.7 % and is significantly higher for mixed (24.6 %) compared with pure (9.0 %) DM. We believe that these rates are sufficient to justify consideration of SLNB for both histologic variants, especially since detection of SLN disease appears to predict a higher risk for melanoma-related death.

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U2 - 10.1245/s10434-013-2883-z

DO - 10.1245/s10434-013-2883-z

M3 - Review article

VL - 20

SP - 2345

EP - 2351

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 7

ER -