The prognostic significance of sentinel node tumour burden in melanoma patients: An international, multicenter study of 1539 sentinel node-positive melanoma patients

Abstract Introduction Sentinel node (SN) biopsy (SNB) and completion lymph node dissection (CLND) when SN-positive have become standard of care in most cancer centres for melanoma. Various SN tumour burden parameters are assessed to determine the heterogeneity of SN-positivity. The aim of the presen...

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Bibliographic Details
Published in:European journal of cancer (1990) 2014-01, Vol.50 (1), p.111-120
Main Authors: van der Ploeg, Augustinus P.T, van Akkooi, Alexander C.J, Haydu, Lauren E, Scolyer, Richard A, Murali, Rajmohan, Verhoef, Cornelis, Thompson, John F, Eggermont, Alexander M.M
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cohort Studies
Female
Hematology, Oncology and Palliative Medicine
Humans
Lymph Node Excision
Lymph Nodes - pathology
Lymph Nodes - surgery
Male
Medical sciences
Melanoma
Melanoma - pathology
Melanoma - surgery
Middle Aged
Pathology and survival
Pharmacology. Drug treatments
Prognosis
Retrospective Studies
Sentinel Lymph Node Biopsy - methods
Sentinel node biopsy
Survival Analysis
Tumor Burden
Tumors
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Summary:Abstract Introduction Sentinel node (SN) biopsy (SNB) and completion lymph node dissection (CLND) when SN-positive have become standard of care in most cancer centres for melanoma. Various SN tumour burden parameters are assessed to determine the heterogeneity of SN-positivity. The aim of the present study was to validate the prognostic significance of various SN tumour burden micromorphometric features and classification schemes in a large cohort of SN-positive melanoma patients. Methods In 1539 SN-positive patients treated between 1993 and 2008 at 11 melanoma treatment centres in Europe and Australia, indices of SN tumour burden (intranodal location, tumour penetrative depth (TPD) and maximum size of SN tumour deposits) were evaluated. Results Non-subcapsular location, increasing TPD and increasing maximum size were all predictive factors for non-SN (NSN) status and were independently associated with poorer melanoma-specific survival (MSS). Patients with subcapsular micrometastases 1 mm was the most reliable and consistent parameter independently associated with higher non-SN-positivity, poorer disease-free survival (DFS) and poorer MSS. Conclusions In this large retrospective, multicenter cohort study, several parameters of SN tumour burden including intranodal location, TPD and maximum size provided prognostic information, but their prognostic significance varied considerably between the different centres. This could be due to sample size limitations or to differences in SN detection, removal and examination techniques.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2013.08.023