An increased number of sentinel lymph nodes is associated with advanced breslow depth and lymphovascular invasion in patients with primary melanoma Journal Article


Authors: Schmidt, C. R.; Panageas, K. S.; Coit, D. G.; Patel, A.; Brady, M. S.
Article Title: An increased number of sentinel lymph nodes is associated with advanced breslow depth and lymphovascular invasion in patients with primary melanoma
Abstract: Background: The pathologic status of the sentinel lymph node (SLN) is a powerful prognostic factor for patients with intermediate thickness melanoma. We hypothesize that a high number of SLNs identified may be associated with poor outcome. Methods: We evaluated the impact of number of SLNs removed in patients undergoing SLN mapping for cutaneous melanoma at our institution between 1996 and 2006. We excluded patients with multiple primary or synchronous primary lesions (n = 144) to eliminate any chance of erroneous association between a SLN and the wrong primary melanoma. We also excluded patients with in-transit disease (n = 37) and one patient in whom no SLN was identified, leaving 970 patients. We evaluated factors associated with the number of SLNs removed by multivariate Poisson regression and determined whether an increased number of SLNs was associated with poorer overall (OS) or recurrence-free survival (RFS). Results: Clinical factors independently associated with increased number of SLNs were younger age and head and neck primary site. Pathologic factors associated with an increased number of SLNs were lymphovascular invasion and increased Breslow thickness. There was no association between number of SLNs removed and OS or RFS in all patients or in patients with negative SLNs (n = 803). Conclusions: The number of SLNs identified during staging of the regional nodal basin for primary melanoma is not an independent prognostic factor. Drainage to multiple SLNs is more common in the setting of an increased Breslow depth and lymphovascular invasion suggesting that tumors with these adverse features may enhance peritumoral lymphangiogenesis. © 2009 Society of Surgical Oncology.
Keywords: adult; controlled study; human tissue; middle aged; survival analysis; major clinical study; cancer recurrence; disease free survival; lymph node metastasis; lymph nodes; lymphatic metastasis; lymphoscintigraphy; sentinel lymph node; sentinel lymph node biopsy; melanoma; skin neoplasms; cancer invasion; lymph vessel; cancer regression; neoplasm invasiveness; lymph node biopsy
Journal Title: Annals of Surgical Oncology
Volume: 16
Issue: 4
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2009-04-01
Start Page: 948
End Page: 952
Language: English
DOI: 10.1245/s10434-009-0331-x
PUBMED: 19194758
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 30 November 2010" - "CODEN: ASONF" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Katherine S Panageas
    332 Panageas
  2. Mary Sue Brady
    169 Brady
  3. Daniel Coit
    428 Coit
  4. Ami Patel
    3 Patel