Sentinel lymph node biopsy in patients with T1a cutaneous malignant melanoma: A multicenter cohort study - 14/12/22
Abstract |
Background |
Sentinel lymph node biopsy is not routinely recommended for T1a cutaneous melanoma due to the overall low risk of positivity. Prognostic factors for positive sentinel lymph node (SLN+) in this population are poorly characterized.
Objective |
To determine factors associated with SLN+ in patients with T1a melanoma.
Methods |
Patients with pathologic T1a (<0.80 mm, nonulcerated) cutaneous melanoma from 5 high-volume melanoma centers from 2001 to 2020 who underwent wide local excision with sentinel lymph node biopsy were included in the study. Patient and tumor characteristics associated with SLN+ were analyzed by univariate and multivariable logistic regression analyses. Age was dichotomized into ≤42 (25% quartile cutoff) and >42 years.
Results |
Of the 965 patients identified, the overall SLN+ was 4.4% (N = 43). Factors associated with SLN+ were age ≤42 years (7.5% vs 3.7%; odds ratio [OR], 2.14; P = .03), head/neck primary tumor location (9.2% vs 4%; OR, 2.75; P = .04), lymphovascular invasion (21.4% vs 4.2%; OR, 5.64; P = .01), and ≥2 mitoses/mm2 (8.2% vs 3.4%; OR, 2.31; P = .03). Patients <42 years with ≥2 mitoses/mm2 (N = 38) had a SLN+ rate of 18.4%.
Limitations |
Retrospective study.
Conclusion |
SLN+ is low in patients with T1a melanomas, but younger age, lymphovascular invasion, mitogenicity, and head/neck primary site appear to confer a higher risk of SLN+.
Le texte complet de cet article est disponible en PDF.Key words : melanoma, prognosis, sentinel lymph node biopsy, surgery, survival, wide local excision
Abbreviations used : DSS, LVI, OR, PNI, SLN, SLN−, SLN+, SLNB, WLE
Plan
Drs Zager and Karakousis contributed equally to this article as senior authors. |
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Drs Shannon and Sharon contributed equally to this article as first authors. |
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Funding sources: Sondak’s relevant financial activities outside the submitted work include BMS, Eisai, Iovance, Novartis, and Regeneron, and he receives research support from Neogene and Turnstone. Bartlett receives institutional research support from SkylineDx and discloses an honorarium from Excite International. |
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IRB approval status: Reviewed and determined to be exempt by the University of Pennsylvania IRB, protocol # 843609. |
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Patient consent: No identifiable material, including photographs or identifiable medical information, is included in this manuscript. All included data are de-identified, and as such, this manuscript has been determined to be exempt by the IRB. |
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Reprints not available from the authors. |
Vol 88 - N° 1
P. 52-59 - janvier 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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