Histological features of melanoma sentinel lymph node metastases associated with status of the completion lymphadenectomy and rate of subsequent relapse.

Ann Surg Oncol 2007 Feb 29;14(2):906-12. Epub 2006 Nov 29.

Division of General Surgery, University of Toronto, Toronto, ON, Canada.

Background: The current recommendation for patients with cutaneous melanoma and a positive sentinel lymph node (SLN) biopsy is a completion lymph node dissection (CLND). This study sought to define a population of SLN-positive patients, based on their histological pattern of SLN metastases, who may not require CLND.

Methods: All patients with SLN-positive cutaneous melanoma who underwent CLND between March 1999 and December 2004 at a single academic institution were enrolled. Metastatic deposits in the SLN were categorized by their histological zone of involvement (subcapsular, parenchymal and/or sinusoidal). Logistic regression was used to examine the effect of SLN zone, size of nodal metastases, and other histological factors on CLND positivity. Kaplan-Meier and Cox models were used to study disease recurrence.

Results: A total of 127 patients were included, and 15.8% had positive non-sentinel nodes. In adjusted analyses, the size of the largest tumor deposit in the SLN was the only factor associated with CLND status. No patients with a tumor deposit
Conclusion: Histologic features of tumor metastases in positive SLN may be useful in defining a population of patients who may be spared CLND and a group at high risk of recurrence.

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http://www.springerlink.com/index/10.1245/s10434-006-9241-3
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http://dx.doi.org/10.1245/s10434-006-9241-3DOI Listing
February 2007
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References

(Supplied by CrossRef)

A Jemal et al.
CA Cancer J Clin 2004

AD Chan et al.
J Am Coll Surg 2000

CM Balch et al.
J Clin Oncol 2001

D Reintgen et al.
Ann Surg 1997

DS Reintgen et al.
Ann Surg Oncol 2004

L Ryan et al.
Cancer 1993

DL Morton et al.
Arch Surg 1992

SPL Leong et al.
Curr Treat Options Oncol 2004

KM McMasters et al.
J Clin Oncol 2001

N Elias et al.
Arch Surg 2004

JF Thompson et al.
Ann Surg Oncol 2004

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