Sentinel lymph node staging of cutaneous melanoma: predictors and outcomes

Michelle C. Ellis, Roshanthi Weerasinghe, Christopher Corless, John Vetto

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: The authors updated their experience with sentinel lymph node (SLN) biopsy of clinically node negative (N0) melanoma to clarify indications, predictive factors, and outcomes. Methods: A review of patients from the authors' institution's prospective database (n = 397) was performed; survival statistics were obtained from the institutional tumor registry. Results: The SLN-positive (SLN+) rate was 16% (47 of 282) for lesions >1 mm thick; only 2 of 105 T1 lesions were SLN+. Thickness >2 mm, upper extremity primary, and ulceration predicted SLN+ status. Most SLN+ patients underwent completion node dissection; 12% had additional positive nodes. The false-negative SLN biopsy rate was 4.0%; the majority involved lower extremity and head and neck primaries. The overall complication rate was 26%; all were minor and resolved within 6 months. Overall 5-year survival rates were 73% and 92% for SLN+ and SLN-negative patients, respectively. SLN status was the most significant predictor of survival. Conclusions: SLN status, the most important determinant of outcome for clinically N0 melanoma, correlated with T stage, ulceration, and site. Staging of T1 lesions had low yield. A minority of completion node dissections yielded additional positive nodes.

Original languageEnglish (US)
Pages (from-to)663-668
Number of pages6
JournalAmerican Journal of Surgery
Volume199
Issue number5
DOIs
StatePublished - May 2010
Externally publishedYes

Fingerprint

Melanoma
Skin
Sentinel Lymph Node Biopsy
Dissection
Sentinel Lymph Node
Survival
Upper Extremity
Registries
Lower Extremity
Neck
Survival Rate
Head
Databases
Neoplasms

Keywords

  • Completion lymph node dissection
  • Complications
  • False negative
  • Melanoma
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Surgery

Cite this

Sentinel lymph node staging of cutaneous melanoma : predictors and outcomes. / Ellis, Michelle C.; Weerasinghe, Roshanthi; Corless, Christopher; Vetto, John.

In: American Journal of Surgery, Vol. 199, No. 5, 05.2010, p. 663-668.

Research output: Contribution to journalArticle

@article{5b33764def83425ea55ec676688c6e18,
title = "Sentinel lymph node staging of cutaneous melanoma: predictors and outcomes",
abstract = "Background: The authors updated their experience with sentinel lymph node (SLN) biopsy of clinically node negative (N0) melanoma to clarify indications, predictive factors, and outcomes. Methods: A review of patients from the authors' institution's prospective database (n = 397) was performed; survival statistics were obtained from the institutional tumor registry. Results: The SLN-positive (SLN+) rate was 16{\%} (47 of 282) for lesions >1 mm thick; only 2 of 105 T1 lesions were SLN+. Thickness >2 mm, upper extremity primary, and ulceration predicted SLN+ status. Most SLN+ patients underwent completion node dissection; 12{\%} had additional positive nodes. The false-negative SLN biopsy rate was 4.0{\%}; the majority involved lower extremity and head and neck primaries. The overall complication rate was 26{\%}; all were minor and resolved within 6 months. Overall 5-year survival rates were 73{\%} and 92{\%} for SLN+ and SLN-negative patients, respectively. SLN status was the most significant predictor of survival. Conclusions: SLN status, the most important determinant of outcome for clinically N0 melanoma, correlated with T stage, ulceration, and site. Staging of T1 lesions had low yield. A minority of completion node dissections yielded additional positive nodes.",
keywords = "Completion lymph node dissection, Complications, False negative, Melanoma, Sentinel lymph node biopsy",
author = "Ellis, {Michelle C.} and Roshanthi Weerasinghe and Christopher Corless and John Vetto",
year = "2010",
month = "5",
doi = "10.1016/j.amjsurg.2010.01.019",
language = "English (US)",
volume = "199",
pages = "663--668",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Sentinel lymph node staging of cutaneous melanoma

T2 - predictors and outcomes

AU - Ellis, Michelle C.

AU - Weerasinghe, Roshanthi

AU - Corless, Christopher

AU - Vetto, John

PY - 2010/5

Y1 - 2010/5

N2 - Background: The authors updated their experience with sentinel lymph node (SLN) biopsy of clinically node negative (N0) melanoma to clarify indications, predictive factors, and outcomes. Methods: A review of patients from the authors' institution's prospective database (n = 397) was performed; survival statistics were obtained from the institutional tumor registry. Results: The SLN-positive (SLN+) rate was 16% (47 of 282) for lesions >1 mm thick; only 2 of 105 T1 lesions were SLN+. Thickness >2 mm, upper extremity primary, and ulceration predicted SLN+ status. Most SLN+ patients underwent completion node dissection; 12% had additional positive nodes. The false-negative SLN biopsy rate was 4.0%; the majority involved lower extremity and head and neck primaries. The overall complication rate was 26%; all were minor and resolved within 6 months. Overall 5-year survival rates were 73% and 92% for SLN+ and SLN-negative patients, respectively. SLN status was the most significant predictor of survival. Conclusions: SLN status, the most important determinant of outcome for clinically N0 melanoma, correlated with T stage, ulceration, and site. Staging of T1 lesions had low yield. A minority of completion node dissections yielded additional positive nodes.

AB - Background: The authors updated their experience with sentinel lymph node (SLN) biopsy of clinically node negative (N0) melanoma to clarify indications, predictive factors, and outcomes. Methods: A review of patients from the authors' institution's prospective database (n = 397) was performed; survival statistics were obtained from the institutional tumor registry. Results: The SLN-positive (SLN+) rate was 16% (47 of 282) for lesions >1 mm thick; only 2 of 105 T1 lesions were SLN+. Thickness >2 mm, upper extremity primary, and ulceration predicted SLN+ status. Most SLN+ patients underwent completion node dissection; 12% had additional positive nodes. The false-negative SLN biopsy rate was 4.0%; the majority involved lower extremity and head and neck primaries. The overall complication rate was 26%; all were minor and resolved within 6 months. Overall 5-year survival rates were 73% and 92% for SLN+ and SLN-negative patients, respectively. SLN status was the most significant predictor of survival. Conclusions: SLN status, the most important determinant of outcome for clinically N0 melanoma, correlated with T stage, ulceration, and site. Staging of T1 lesions had low yield. A minority of completion node dissections yielded additional positive nodes.

KW - Completion lymph node dissection

KW - Complications

KW - False negative

KW - Melanoma

KW - Sentinel lymph node biopsy

UR - http://www.scopus.com/inward/record.url?scp=77951910215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951910215&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2010.01.019

DO - 10.1016/j.amjsurg.2010.01.019

M3 - Article

C2 - 20466113

AN - SCOPUS:77951910215

VL - 199

SP - 663

EP - 668

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 5

ER -