Transected thin melanoma: Implications for sentinel lymph node staging Journal Article
| Authors: | Herbert, G.; Karakousis, G. C.; Bartlett, E. K.; Zaheer, S.; Graham, D.; Czerniecki, B. J.; Fraker, D. L.; Ariyan, C.; Coit, D. G.; Brady, M. S. |
| Article Title: | Transected thin melanoma: Implications for sentinel lymph node staging |
| Abstract: | Background and Objectives: Indications for sentinel lymph node (SLN) biopsy in patients with thin melanoma (≤1 mm thick) are controversial. We asked whether deep margin (DM) positivity at initial biopsy of thin melanoma is associated with SLN positivity. Methods: Cases were identified using prospectively maintained databases at two melanoma centers. Patients who had undergone SLN biopsy for melanoma ≤1 mm were included. DM status was assessed for association with SLN metastasis in univariate and multivariate analyses. Results: 1413 cases were identified, but only 1129 with known DM status were included. 39% of patients had a positive DM on original biopsy. DM-positive and DM-negative patients did not differ significantly in primary thickness, ulceration, or mitotic activity. DM-positive and DM-negative patients had similar incidence of SLN metastasis (5.7% vs 3.5%; P = 0.07). Positive DM was not associated with SLN metastasis on univariate analysis (OR 1.69, 95% CI: 0.95-3.00, P = 0.07) or on multivariate analysis adjusted for Breslow depth, Clark level, mitotic rate, and ulceration (OR = 1.59, 95% CI: 0.89-2.85; P = 0.12). Conclusions: For patients with thin melanoma, a positive DM on initial biopsy is not associated with risk of SLN metastasis, so DM positivity should not be considered an indication for SLN staging in an otherwise low-risk patient. © 2017 Wiley Periodicals, Inc. |
| Keywords: | adult; human tissue; middle aged; primary tumor; retrospective studies; major clinical study; cancer patient; cancer staging; lymph node metastasis; cancer incidence; lymphatic metastasis; neoplasm staging; sentinel lymph node; sentinel lymph node biopsy; melanoma; skin neoplasms; tumor volume; clinical assessment; tumor biopsy; pathology; retrospective study; skin tumor; mitosis rate; factual database; databases, factual; surgical margin; wide excision; thickness; procedures; sentinel lymph node metastasis; humans; human; male; female; priority journal; article; thin; transected; deep margin; ulcer incidence |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 117 |
| Issue: | 4 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2018-03-15 |
| Start Page: | 567 |
| End Page: | 571 |
| Language: | English |
| DOI: | 10.1002/jso.24930 |
| PUBMED: | 29194673 |
| PROVIDER: | scopus |
| PMCID: | PMC5878707 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 May 2018 -- Source: Scopus |
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