Sentinel lymph node biopsy is indicated for patients with thick clinically lymph node‐negative melanoma

BACKGROUND Sentinel lymph node biopsy (SLNB) is indicated for the staging of clinically lymph node‐negative melanoma of intermediate thickness, but its use is controversial in patients with thick melanoma. METHODS From 2002 to 2012, patients with melanoma measuring ≥4 mm in thickness were evaluated...

Full description

Saved in:
Bibliographic Details
Published in:Cancer 2015-05, Vol.121 (10), p.1628-1636
Main Authors: Yamamoto, Maki, Fisher, Kate J., Wong, Joyce Y., Koscso, Jonathan M., Konstantinovic, Monique A., Govsyeyev, Nicholas, Messina, Jane L., Sarnaik, Amod A., Cruse, C. Wayne, Gonzalez, Ricardo J., Sondak, Vernon K., Zager, Jonathan S.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Breslow depth
Disease-Free Survival
false‐negative rate
Female
Humans
Kaplan-Meier Estimate
Logistic Models
Lymph Nodes - pathology
Lymphatic Metastasis - diagnosis
Male
melanoma
Melanoma - pathology
Melanoma - surgery
Middle Aged
Predictive Value of Tests
Prognosis
Sentinel Lymph Node Biopsy
Skin Neoplasms - pathology
Skin Neoplasms - surgery
thick melanoma
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND Sentinel lymph node biopsy (SLNB) is indicated for the staging of clinically lymph node‐negative melanoma of intermediate thickness, but its use is controversial in patients with thick melanoma. METHODS From 2002 to 2012, patients with melanoma measuring ≥4 mm in thickness were evaluated at a single institution. Associations between survival and clinicopathologic characteristics were explored. RESULTS Of 571 patients with melanomas measuring ≥4 mm in thickness and no distant metastases, the median age was 66 years and 401 patients (70.2%) were male. The median Breslow thickness was 6.2 mm; the predominant subtype was nodular (45.4%). SLNB was performed in 412 patients (72%) whereas 46 patients (8.1%) presented with clinically lymph node‐positive disease and 113 patients (20%) did not undergo SLNB. A positive SLN was found in 161 of 412 patients (39.1%). For SLNB performed at the study institution, 14 patients with a negative SLNB developed disease recurrence in the mapped lymph node basin (false‐negative rate, 12.3%). The median disease‐specific survival (DSS), overall survival (OS), and recurrence‐free survival (RFS) for the entire cohort were 62.1 months, 42.5 months, and 21.2 months, respectively. The DSS and OS for patients with a negative SLNB were 82.4 months and 53.4 months, respectively; 41.2 months and 34.7 months, respectively, for patients with positive SLNB; and 26.8 months and 22 months, respectively, for patients with clinically lymph node‐positive disease (P
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.29239