Stratifying SLN incidence in intermediate thickness melanoma patients - 20/03/18
Abstract |
Background |
Guidelines for melanoma recommend sentinel lymph node biopsy (SLNB) in patients with melanomas ≥1 mm thickness. Recent single institution studies have found tumors <1.5 mm a low-risk group for positive SLNB.
Methods |
A retrospective review of the Sentinel Lymph Node Working Group multicenter database identified patients with intermediate thickness melanoma (1.01–4.00 mm) who had SLNB, and assessed predictors for positive SLNB.
Results |
3460 patients were analyzed, 584 (17%) had a positive SLNB. Univariate factors associated with a positive SLNB included age <60 (p < .001), tumor on the trunk/lower extremity (p < .001), Breslow depth ≥2 mm (p < .001), ulceration (p < .001), mitotic rate ≥1/mm2 (p = .01), and microsatellitosis (p < .001). Multivariate analysis revealed age, location, and Breslow depth as significant predictors. Patients ≥75 with lesions 1.01–1.49 mm on the head/neck/upper extremity and 1.5–1.99 mm without high-risk features had <5% risk of SLN positivity.
Conclusions |
Intermediate thickness melanoma has significant heterogeneity of SLNB positivity. Low-risk subgroups can be found among older patients in the absence of high-risk features.
El texto completo de este artículo está disponible en PDF.Highlights |
• | Intermediate thickness melanoma has heterogeneous risk for nodal metastases. |
• | Groups that are low risk for nodal metastases may be spared a sentinel lymph node biopsy. |
• | Elderly patients in particular may have low risk of nodal metastases. |
Esquema
Vol 215 - N° 4
P. 699-706 - avril 2018 Regresar al número
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