Document Detail

Importance of sentinel lymph node biopsy in patients with thin melanoma.
MedLine Citation:
PMID:  18794428     Owner:  NLM     Status:  MEDLINE    
HYPOTHESIS: The status of the sentinel node (SN) confers important prognostic information for patients with thin melanoma. DESIGN, SETTING, AND PATIENTS: We queried our melanoma database to identify patients undergoing sentinel lymph node biopsy for thin (< or =1.00-mm) cutaneous melanoma at a tertiary care cancer institute. Slides of tumor-positive SNs were reviewed by a melanoma pathologist to confirm nodal status and intranodal tumor burden, defined as isolated tumor cells, micrometastasis, or macrometastasis (< or =0.20, 0.21-2.00, or >2.00 mm, respectively). Nodal status was correlated with patient age and primary tumor depth (< or = 0.25, 0.26-0.50, 0.51-0.75, or 0.76-1.00 mm). Survival was determined by log-rank test. MAIN OUTCOME MEASURES: Disease-free and melanoma-specific survival. RESULTS: Of 1592 patients who underwent sentinel lymph node biopsy from 1991 to 2004, 631 (40%) had thin melanomas; 31 of the 631 patients (5%) had a tumor-positive SN. At a median follow-up of 57 months for the 631 patients, the mean (SD) 10-year rate of disease-free survival was 96% (1%) vs 54% (10%) for patients with tumor-negative vs tumor-positive SNs, respectively (P < .001); the mean (SD) 10-year rate of melanoma-specific survival was 98% (1%) vs 83% (8%), respectively (P < .001). Tumor-positive SNs were more common in patients aged 50 years and younger (P = .04). The SN status maintained importance on multivariate analysis for both disease-free survival (P < .001) and melanoma-specific survival (P < .001). CONCLUSIONS: The status of the SN is significantly linked to survival in patients with thin melanoma. Therefore, sentinel lymph node biopsy should be considered to obtain complete prognostic information.
Byron E Wright; Randall P Scheri; Xing Ye; Mark B Faries; Roderick R Turner; Richard Essner; Donald L Morton
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  143     ISSN:  1538-3644     ISO Abbreviation:  Arch Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-16     Completed Date:  2008-10-27     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  892-9; discussion 899-900     Citation Subset:  AIM; IM    
Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California 90404, USA.
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MeSH Terms
Disease-Free Survival
Melanoma / mortality,  pathology*
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local / pathology
Sentinel Lymph Node Biopsy*
Skin Neoplasms / mortality,  pathology*
Grant Support
CA29605/CA/NCI NIH HHS; P01 CA029605-26/CA/NCI NIH HHS

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