Primary cutaneous melanoma with regression does not require a lower threshold for sentinel lymph node biopsy Journal Article
| Authors: | Morris, K. T.; Busam, K. J.; Bero, S.; Patel, A.; Brady, M. S. |
| Article Title: | Primary cutaneous melanoma with regression does not require a lower threshold for sentinel lymph node biopsy |
| Abstract: | Introduction: Histological evidence of primary tumor regression (RG) is observed in 35% or fewer patients with cutaneous melanoma. Some advocate a lower threshold for sentinel lymph node (SLN) biopsy when RG is present. Methods: We identified 1,349 patients presenting to our center with clinically localized cutaneous melanoma between 1995 and 2004. Of these, 344 demonstrated histological RG in their primary melanoma. A retrospective analysis of their medical records was performed to obtain clinical and pathological information. Results: The median Breslow depth for the 344 patients with RG was 1.1 mm versus 1.5 mm for 1,005 patients with no regression (NRG) (P < 0.005). SLN biopsy was performed in 64% of patients with RG and 72% without. Positive SLN was more common in those with NRG than in those with RG (18% vs 10%, P = 0.005). Only one RG patient with thin melanoma (≤1 mm, Clark IV) had a positive SLN. When stratified by Breslow depth, patients with RG had lower rates of SLN positivity in all groups (≤1.0mm, >1.0 and ≤2.0mm, >2 and ≤4 mm, and >4.0 mm). Recurrence was more common in patients with NRG (21% vs 12%; P < 0.005). Both local and systemic recurrence occurred more commonly in patients with NRG (4% vs 1%, P = 0.002 and 8% vs 3%, P < 0.005, respectively) Conclusions: The presence of histological RG in a primary melanoma predicts neither SLN positivity when stratified by Breslow depth nor increased risk of recurrence when compared with melanomas with NRG. © 2007 Society of Surgical Oncology. |
| Keywords: | survival; adolescent; adult; child; controlled study; human tissue; aged; aged, 80 and over; child, preschool; middle aged; survival rate; major clinical study; histopathology; cancer localization; cancer recurrence; cancer risk; cancer patient; lymphatic metastasis; sentinel lymph node; lymph node excision; prospective studies; sentinel lymph node biopsy; melanoma; neoplasm recurrence, local; skin biopsy; skin neoplasms; recurrence; retrospective study; prediction; tissue section; cancer regression; medical record; predictive value of tests; false negative reactions; regression |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 15 |
| Issue: | 1 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2008-01-01 |
| Start Page: | 316 |
| End Page: | 322 |
| Language: | English |
| DOI: | 10.1245/s10434-007-9675-2 |
| PUBMED: | 18004626 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 20" - "Export Date: 17 November 2011" - "CODEN: ASONF" - "Source: Scopus" |
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