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Clinical Considerations on Sentinel Node Biopsy in Melanoma from an Italian Multicentric Study on 1,313 Patients (SOLISM–IMI)
Background Although widely used for the management of patients with cutaneous melanoma, the sentinel lymph node (SLN) biopsy (SNB) procedure raises several issues. This study was designed to investigate: the predictive factors of SLN status, the false-negative (FN) rate, and patients’ prognosis afte...
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| Published in: | Annals of surgical oncology 2009-07, Vol.16 (7), p.2018-2027 |
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| creator | Testori, Alessandro De Salvo, Gian Luca Montesco, Maria Cristina Trifirò, Giuseppe Mocellin, Simone Landi, Giorgio Macripò, Giuseppe Carcoforo, Paolo Ricotti, Giuseppe Giudice, Giuseppe Picciotto, Franco Donner, Davide Di Filippo, Franco Soteldo, Javier Casara, Dario Schiavon, Mauro Vecchiato, Antonella Pasquali, Sandro Baldini, Federica Mazzarol, Giovanni Rossi, Carlo Riccardo |
| description | Background
Although widely used for the management of patients with cutaneous melanoma, the sentinel lymph node (SLN) biopsy (SNB) procedure raises several issues. This study was designed to investigate: the predictive factors of SLN status, the false-negative (FN) rate, and patients’ prognosis after SNB.
Patients and Methods
This is an observational, prospective study conducted on a large series of consecutive patients (
n
= 1,313) enrolled by 23 Italian centers from 2000 through 2002. A commonly shared protocol was adopted for the SNB surgical procedure and the SLN pathological examination.
Results
The SLN positive and false-negative (FN) rates were 16.9% and 14.4%, respectively (median follow-up, 4.5 years). At multivariable logistic regression analysis, the frequency of positive SLN increased with increasing Breslow thickness (
p
|
| doi_str_mv | 10.1245/s10434-008-0273-8 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67374903</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67374903</sourcerecordid><originalsourceid>FETCH-LOGICAL-c369t-2e581013b6f89535cf3fe43fb5680c0b45f044956f381d462b25995abd0e1e123</originalsourceid><addsrcrecordid>eNp1kc2KFDEUhYM4OOPoA7iR4EIUpjQ3f5VaaqNOQbcjtK5DqiqRDFVJT1K16NX4Dr6hT2KabhgQXN1L7nfOTXIQegHkHVAu3mcgnPGKEFURWrNKPUIXIMoJlwoel55IVTVUinP0NOdbQqBmRDxB59AAo5zLC3S_Gn3wvRnxKobsB5vM7EuHY8BbG2Yf7Ii_xsHijz7u8h77gDd2NCFOBrsUJ2wCbmcz-lI3yzj7vqiS7_F2Xob9wQauGDD8rfiWScZvtjfrdrv58-t3u2nfPkNnzozZPj_VS_Tj86fvq-tqffOlXX1YVz2TzVxRKxQQYJ10qhFM9I45y5nrhFSkJx0XjnDeCOmYgoFL2lHRNMJ0A7FggbJL9Prou0vxbrF51pPPvR3LS2xcspY1q3lDWAFf_QPexiWFcjdNyx8LIXldIDhCfYo5J-v0LvnJpL0Gog_R6GM0ukSjD9FoVTQvT8ZLN9nhQXHKogD0COQyCj9tetj8f9e_Z66X2A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>227355647</pqid></control><display><type>article</type><title>Clinical Considerations on Sentinel Node Biopsy in Melanoma from an Italian Multicentric Study on 1,313 Patients (SOLISM–IMI)</title><source>Springer Nature</source><creator>Testori, Alessandro ; De Salvo, Gian Luca ; Montesco, Maria Cristina ; Trifirò, Giuseppe ; Mocellin, Simone ; Landi, Giorgio ; Macripò, Giuseppe ; Carcoforo, Paolo ; Ricotti, Giuseppe ; Giudice, Giuseppe ; Picciotto, Franco ; Donner, Davide ; Di Filippo, Franco ; Soteldo, Javier ; Casara, Dario ; Schiavon, Mauro ; Vecchiato, Antonella ; Pasquali, Sandro ; Baldini, Federica ; Mazzarol, Giovanni ; Rossi, Carlo Riccardo</creator><creatorcontrib>Testori, Alessandro ; De Salvo, Gian Luca ; Montesco, Maria Cristina ; Trifirò, Giuseppe ; Mocellin, Simone ; Landi, Giorgio ; Macripò, Giuseppe ; Carcoforo, Paolo ; Ricotti, Giuseppe ; Giudice, Giuseppe ; Picciotto, Franco ; Donner, Davide ; Di Filippo, Franco ; Soteldo, Javier ; Casara, Dario ; Schiavon, Mauro ; Vecchiato, Antonella ; Pasquali, Sandro ; Baldini, Federica ; Mazzarol, Giovanni ; Rossi, Carlo Riccardo ; Italian Melanoma Intergroup ; on behalf of the Italian Melanoma Intergroup (IMI)</creatorcontrib><description>Background
Although widely used for the management of patients with cutaneous melanoma, the sentinel lymph node (SLN) biopsy (SNB) procedure raises several issues. This study was designed to investigate: the predictive factors of SLN status, the false-negative (FN) rate, and patients’ prognosis after SNB.
Patients and Methods
This is an observational, prospective study conducted on a large series of consecutive patients (
n
= 1,313) enrolled by 23 Italian centers from 2000 through 2002. A commonly shared protocol was adopted for the SNB surgical procedure and the SLN pathological examination.
Results
The SLN positive and false-negative (FN) rates were 16.9% and 14.4%, respectively (median follow-up, 4.5 years). At multivariable logistic regression analysis, the frequency of positive SLN increased with increasing Breslow thickness (
p
< 0.0001) and decreased in patients with melanoma regression (
p
= 0.024). At the multivariable Cox regression analysis, SLN status was the most important prognostic factor (hazards ratio (HR) = 3.08) for overall survival; the other statistically significant factors were sex, age, Breslow thickness, and Clark’s level. Considering SLN and NSLN status, including FN cases, we identified four groups of patients with different prognoses. The 5-year overall survival of patients with positive SLNs was 71.3% in those with negative nonsentinel lymph nodes (NSLNs) and 50.4% if NSLNs were positive.
Conclusions
Regression in the primary melanoma seems to be a protective factor from metastasis in the SLN. When correctly calculated, the SNB FN rate is 15–20%. Furthermore, the SNB is important to more precisely assess the prognosis of patients with melanoma.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-008-0273-8</identifier><identifier>PMID: 19132446</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; False Negative Reactions ; Female ; Humans ; Italy ; Lymph Nodes - pathology ; Male ; Medicine ; Medicine & Public Health ; Melanoma - mortality ; Melanoma - pathology ; Melanomas ; Middle Aged ; Oncology ; Predictive Value of Tests ; Prognosis ; Sentinel Lymph Node Biopsy ; Skin Neoplasms - mortality ; Skin Neoplasms - pathology ; Surgery ; Surgical Oncology ; Young Adult</subject><ispartof>Annals of surgical oncology, 2009-07, Vol.16 (7), p.2018-2027</ispartof><rights>Society of Surgical Oncology 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-2e581013b6f89535cf3fe43fb5680c0b45f044956f381d462b25995abd0e1e123</citedby><cites>FETCH-LOGICAL-c369t-2e581013b6f89535cf3fe43fb5680c0b45f044956f381d462b25995abd0e1e123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19132446$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Testori, Alessandro</creatorcontrib><creatorcontrib>De Salvo, Gian Luca</creatorcontrib><creatorcontrib>Montesco, Maria Cristina</creatorcontrib><creatorcontrib>Trifirò, Giuseppe</creatorcontrib><creatorcontrib>Mocellin, Simone</creatorcontrib><creatorcontrib>Landi, Giorgio</creatorcontrib><creatorcontrib>Macripò, Giuseppe</creatorcontrib><creatorcontrib>Carcoforo, Paolo</creatorcontrib><creatorcontrib>Ricotti, Giuseppe</creatorcontrib><creatorcontrib>Giudice, Giuseppe</creatorcontrib><creatorcontrib>Picciotto, Franco</creatorcontrib><creatorcontrib>Donner, Davide</creatorcontrib><creatorcontrib>Di Filippo, Franco</creatorcontrib><creatorcontrib>Soteldo, Javier</creatorcontrib><creatorcontrib>Casara, Dario</creatorcontrib><creatorcontrib>Schiavon, Mauro</creatorcontrib><creatorcontrib>Vecchiato, Antonella</creatorcontrib><creatorcontrib>Pasquali, Sandro</creatorcontrib><creatorcontrib>Baldini, Federica</creatorcontrib><creatorcontrib>Mazzarol, Giovanni</creatorcontrib><creatorcontrib>Rossi, Carlo Riccardo</creatorcontrib><creatorcontrib>Italian Melanoma Intergroup</creatorcontrib><creatorcontrib>on behalf of the Italian Melanoma Intergroup (IMI)</creatorcontrib><title>Clinical Considerations on Sentinel Node Biopsy in Melanoma from an Italian Multicentric Study on 1,313 Patients (SOLISM–IMI)</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Although widely used for the management of patients with cutaneous melanoma, the sentinel lymph node (SLN) biopsy (SNB) procedure raises several issues. This study was designed to investigate: the predictive factors of SLN status, the false-negative (FN) rate, and patients’ prognosis after SNB.
Patients and Methods
This is an observational, prospective study conducted on a large series of consecutive patients (
n
= 1,313) enrolled by 23 Italian centers from 2000 through 2002. A commonly shared protocol was adopted for the SNB surgical procedure and the SLN pathological examination.
Results
The SLN positive and false-negative (FN) rates were 16.9% and 14.4%, respectively (median follow-up, 4.5 years). At multivariable logistic regression analysis, the frequency of positive SLN increased with increasing Breslow thickness (
p
< 0.0001) and decreased in patients with melanoma regression (
p
= 0.024). At the multivariable Cox regression analysis, SLN status was the most important prognostic factor (hazards ratio (HR) = 3.08) for overall survival; the other statistically significant factors were sex, age, Breslow thickness, and Clark’s level. Considering SLN and NSLN status, including FN cases, we identified four groups of patients with different prognoses. The 5-year overall survival of patients with positive SLNs was 71.3% in those with negative nonsentinel lymph nodes (NSLNs) and 50.4% if NSLNs were positive.
Conclusions
Regression in the primary melanoma seems to be a protective factor from metastasis in the SLN. When correctly calculated, the SNB FN rate is 15–20%. Furthermore, the SNB is important to more precisely assess the prognosis of patients with melanoma.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>False Negative Reactions</subject><subject>Female</subject><subject>Humans</subject><subject>Italy</subject><subject>Lymph Nodes - pathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melanoma - mortality</subject><subject>Melanoma - pathology</subject><subject>Melanomas</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Skin Neoplasms - mortality</subject><subject>Skin Neoplasms - pathology</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Young Adult</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNp1kc2KFDEUhYM4OOPoA7iR4EIUpjQ3f5VaaqNOQbcjtK5DqiqRDFVJT1K16NX4Dr6hT2KabhgQXN1L7nfOTXIQegHkHVAu3mcgnPGKEFURWrNKPUIXIMoJlwoel55IVTVUinP0NOdbQqBmRDxB59AAo5zLC3S_Gn3wvRnxKobsB5vM7EuHY8BbG2Yf7Ii_xsHijz7u8h77gDd2NCFOBrsUJ2wCbmcz-lI3yzj7vqiS7_F2Xob9wQauGDD8rfiWScZvtjfrdrv58-t3u2nfPkNnzozZPj_VS_Tj86fvq-tqffOlXX1YVz2TzVxRKxQQYJ10qhFM9I45y5nrhFSkJx0XjnDeCOmYgoFL2lHRNMJ0A7FggbJL9Prou0vxbrF51pPPvR3LS2xcspY1q3lDWAFf_QPexiWFcjdNyx8LIXldIDhCfYo5J-v0LvnJpL0Gog_R6GM0ukSjD9FoVTQvT8ZLN9nhQXHKogD0COQyCj9tetj8f9e_Z66X2A</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Testori, Alessandro</creator><creator>De Salvo, Gian Luca</creator><creator>Montesco, Maria Cristina</creator><creator>Trifirò, Giuseppe</creator><creator>Mocellin, Simone</creator><creator>Landi, Giorgio</creator><creator>Macripò, Giuseppe</creator><creator>Carcoforo, Paolo</creator><creator>Ricotti, Giuseppe</creator><creator>Giudice, Giuseppe</creator><creator>Picciotto, Franco</creator><creator>Donner, Davide</creator><creator>Di Filippo, Franco</creator><creator>Soteldo, Javier</creator><creator>Casara, Dario</creator><creator>Schiavon, Mauro</creator><creator>Vecchiato, Antonella</creator><creator>Pasquali, Sandro</creator><creator>Baldini, Federica</creator><creator>Mazzarol, Giovanni</creator><creator>Rossi, Carlo Riccardo</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20090701</creationdate><title>Clinical Considerations on Sentinel Node Biopsy in Melanoma from an Italian Multicentric Study on 1,313 Patients (SOLISM–IMI)</title><author>Testori, Alessandro ; De Salvo, Gian Luca ; Montesco, Maria Cristina ; Trifirò, Giuseppe ; Mocellin, Simone ; Landi, Giorgio ; Macripò, Giuseppe ; Carcoforo, Paolo ; Ricotti, Giuseppe ; Giudice, Giuseppe ; Picciotto, Franco ; Donner, Davide ; Di Filippo, Franco ; Soteldo, Javier ; Casara, Dario ; Schiavon, Mauro ; Vecchiato, Antonella ; Pasquali, Sandro ; Baldini, Federica ; Mazzarol, Giovanni ; Rossi, Carlo Riccardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-2e581013b6f89535cf3fe43fb5680c0b45f044956f381d462b25995abd0e1e123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>False Negative Reactions</topic><topic>Female</topic><topic>Humans</topic><topic>Italy</topic><topic>Lymph Nodes - pathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Melanoma - mortality</topic><topic>Melanoma - pathology</topic><topic>Melanomas</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Skin Neoplasms - mortality</topic><topic>Skin Neoplasms - pathology</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Testori, Alessandro</creatorcontrib><creatorcontrib>De Salvo, Gian Luca</creatorcontrib><creatorcontrib>Montesco, Maria Cristina</creatorcontrib><creatorcontrib>Trifirò, Giuseppe</creatorcontrib><creatorcontrib>Mocellin, Simone</creatorcontrib><creatorcontrib>Landi, Giorgio</creatorcontrib><creatorcontrib>Macripò, Giuseppe</creatorcontrib><creatorcontrib>Carcoforo, Paolo</creatorcontrib><creatorcontrib>Ricotti, Giuseppe</creatorcontrib><creatorcontrib>Giudice, Giuseppe</creatorcontrib><creatorcontrib>Picciotto, Franco</creatorcontrib><creatorcontrib>Donner, Davide</creatorcontrib><creatorcontrib>Di Filippo, Franco</creatorcontrib><creatorcontrib>Soteldo, Javier</creatorcontrib><creatorcontrib>Casara, Dario</creatorcontrib><creatorcontrib>Schiavon, Mauro</creatorcontrib><creatorcontrib>Vecchiato, Antonella</creatorcontrib><creatorcontrib>Pasquali, Sandro</creatorcontrib><creatorcontrib>Baldini, Federica</creatorcontrib><creatorcontrib>Mazzarol, Giovanni</creatorcontrib><creatorcontrib>Rossi, Carlo Riccardo</creatorcontrib><creatorcontrib>Italian Melanoma Intergroup</creatorcontrib><creatorcontrib>on behalf of the Italian Melanoma Intergroup (IMI)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Testori, Alessandro</au><au>De Salvo, Gian Luca</au><au>Montesco, Maria Cristina</au><au>Trifirò, Giuseppe</au><au>Mocellin, Simone</au><au>Landi, Giorgio</au><au>Macripò, Giuseppe</au><au>Carcoforo, Paolo</au><au>Ricotti, Giuseppe</au><au>Giudice, Giuseppe</au><au>Picciotto, Franco</au><au>Donner, Davide</au><au>Di Filippo, Franco</au><au>Soteldo, Javier</au><au>Casara, Dario</au><au>Schiavon, Mauro</au><au>Vecchiato, Antonella</au><au>Pasquali, Sandro</au><au>Baldini, Federica</au><au>Mazzarol, Giovanni</au><au>Rossi, Carlo Riccardo</au><aucorp>Italian Melanoma Intergroup</aucorp><aucorp>on behalf of the Italian Melanoma Intergroup (IMI)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Considerations on Sentinel Node Biopsy in Melanoma from an Italian Multicentric Study on 1,313 Patients (SOLISM–IMI)</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2009-07-01</date><risdate>2009</risdate><volume>16</volume><issue>7</issue><spage>2018</spage><epage>2027</epage><pages>2018-2027</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Although widely used for the management of patients with cutaneous melanoma, the sentinel lymph node (SLN) biopsy (SNB) procedure raises several issues. This study was designed to investigate: the predictive factors of SLN status, the false-negative (FN) rate, and patients’ prognosis after SNB.
Patients and Methods
This is an observational, prospective study conducted on a large series of consecutive patients (
n
= 1,313) enrolled by 23 Italian centers from 2000 through 2002. A commonly shared protocol was adopted for the SNB surgical procedure and the SLN pathological examination.
Results
The SLN positive and false-negative (FN) rates were 16.9% and 14.4%, respectively (median follow-up, 4.5 years). At multivariable logistic regression analysis, the frequency of positive SLN increased with increasing Breslow thickness (
p
< 0.0001) and decreased in patients with melanoma regression (
p
= 0.024). At the multivariable Cox regression analysis, SLN status was the most important prognostic factor (hazards ratio (HR) = 3.08) for overall survival; the other statistically significant factors were sex, age, Breslow thickness, and Clark’s level. Considering SLN and NSLN status, including FN cases, we identified four groups of patients with different prognoses. The 5-year overall survival of patients with positive SLNs was 71.3% in those with negative nonsentinel lymph nodes (NSLNs) and 50.4% if NSLNs were positive.
Conclusions
Regression in the primary melanoma seems to be a protective factor from metastasis in the SLN. When correctly calculated, the SNB FN rate is 15–20%. Furthermore, the SNB is important to more precisely assess the prognosis of patients with melanoma.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>19132446</pmid><doi>10.1245/s10434-008-0273-8</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Annals of surgical oncology, 2009-07, Vol.16 (7), p.2018-2027 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67374903 |
| source | Springer Nature |
| subjects | Adolescent Adult Aged Aged, 80 and over False Negative Reactions Female Humans Italy Lymph Nodes - pathology Male Medicine Medicine & Public Health Melanoma - mortality Melanoma - pathology Melanomas Middle Aged Oncology Predictive Value of Tests Prognosis Sentinel Lymph Node Biopsy Skin Neoplasms - mortality Skin Neoplasms - pathology Surgery Surgical Oncology Young Adult |
| title | Clinical Considerations on Sentinel Node Biopsy in Melanoma from an Italian Multicentric Study on 1,313 Patients (SOLISM–IMI) |
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