The Prognostic Significance of Sentinel Lymph Node Status for Patients with Thick Melanoma. Academic Article uri icon

abstract

  • BACKGROUND: Sentinel lymph node biopsy (SLNB) is recommended for patients with intermediate-thickness melanoma, but the use of SLNB for patients with thick melanoma is debated. This report presents a single-institution study investigating factors predictive of sentinel lymph node (SLN) metastasis and outcome for thick-melanoma patients . METHODS: A retrospective review of a single-institution database from 1997 to 2012 identified 147 patients with thick primary cutaneous melanoma (4mm) who had an SLNB. Clinicopathologic characteristics were correlated with nodal status and outcome. RESULTS: The median age of the patients was 67years, and 61.9% of the patients were men. The median tumor thickness was 5.5mm, and 54 patients (36.7%) had a positive SLN. Multivariable analysis showed that only tumor thickness significantly predicted SLN metastasis (odds ratio 1.14; 95% confidence interval (CI) 1.02-1.28; P=0.02). The overall median follow-up period was 34.6months. Overall survival (OS) and melanoma-specific survival (MSS) were significantly worse for the positive versus negative-SLN patients. Multivariable analysis showed that age [hazard ratio (HR) 1.04; 95% CI 1.01-1.07; P=0.02] and SLN status (HR 2.24; 95% CI 1.03-4.88; P=0.04) significantly predicted OS, whereas only SLN status (HR 3.85; 95% CI 2.13-6.97; P<0.01) significantly predicted MSS. CONCLUSIONS: Tumor thickness predicts SLN status in thick melanomas. Furthermore, SLN status is prognostic for OS and MSS in thick-melanoma patients, with positive-SLN patients having significantly worse OS and MSS. These findings show that SLNB should be recommended for thick-melanoma patients, particularly because detection of SLN metastasis can identify patients for potential systemic therapy and treatment of nodal disease at a microscopic stage.

published proceedings

  • Ann Surg Oncol

altmetric score

  • 5.2

author list (cited authors)

  • Bello, D. M., Han, G., Jackson, L., Bulloch, K., Ariyan, S., Narayan, D., Rothberg, B. G., & Han, D.

citation count

  • 25

complete list of authors

  • Bello, Danielle M||Han, Gang||Jackson, Laura||Bulloch, Kaleigh||Ariyan, Stephan||Narayan, Deepak||Rothberg, Bonnie Gould||Han, Dale

publication date

  • December 2016