Annals of Surgical Oncology

, Volume 18, Issue 13, pp 3593–3600

Factors Predictive of the Status of Sentinel Lymph Nodes in Melanoma Patients from a Large Multicenter Database

  • Richard L. WhiteJr.
  • Gregory D. Ayers
  • Virginia H. Stell
  • Shouluan Ding
  • Jeffrey E. Gershenwald
  • Jonathan C. Salo
  • Barbara A. Pockaj
  • Richard Essner
  • Mark Faries
  • Kim James Charney
  • Eli Avisar
  • Axel Hauschild
  • Friederike Egberts
  • Bruce J. Averbook
  • Carlos A. Garberoglio
  • John T. Vetto
  • Merrick I. Ross
  • David Chu
  • Vijay Trisal
  • Harald Hoekstra
  • Eric Whitman
  • Harold J. Wanebo
  • Daniel DeBonis
  • Michael Vezeridis
  • Aaron Chevinsky
  • Mohammed Kashani-Sabet
  • Yu Shyr
  • Lynne Berry
  • Zhiguo Zhao
  • Seng-jaw Soong
  • Stanley P. L. Leong
  • for the Sentinel Lymph Node Working Group
Melanomas

Abstract

Background

Numerous predictive factors for cutaneous melanoma metastases to sentinel lymph nodes have been identified; however, few have been found to be reproducibly significant. This study investigated the significance of factors for predicting regional nodal disease in cutaneous melanoma using a large multicenter database.

Methods

Seventeen institutions submitted retrospective and prospective data on 3463 patients undergoing sentinel lymph node (SLN) biopsy for primary melanoma. Multiple demographic and tumor factors were analyzed for correlation with a positive SLN. Univariate and multivariate statistical analyses were performed.

Results

Of 3445 analyzable patients, 561 (16.3%) had a positive SLN biopsy. In multivariate analysis of 1526 patients with complete records for 10 variables, increasing Breslow thickness, lymphovascular invasion, ulceration, younger age, the absence of regression, and tumor location on the trunk were statistically significant predictors of a positive SLN.

Conclusions

These results confirm the predictive significance of the well-established variables of Breslow thickness, ulceration, age, and location, as well as consistently reported but less well-established variables such as lymphovascular invasion. In addition, the presence of regression was associated with a lower likelihood of a positive SLN. Consideration of multiple tumor parameters should influence the decision for SLN biopsy and the estimation of nodal metastatic disease risk.

Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Richard L. WhiteJr.
    • 1
  • Gregory D. Ayers
    • 2
  • Virginia H. Stell
    • 1
  • Shouluan Ding
    • 3
  • Jeffrey E. Gershenwald
    • 4
  • Jonathan C. Salo
    • 1
  • Barbara A. Pockaj
    • 5
  • Richard Essner
    • 6
  • Mark Faries
    • 6
  • Kim James Charney
    • 7
  • Eli Avisar
    • 8
  • Axel Hauschild
    • 9
  • Friederike Egberts
    • 9
  • Bruce J. Averbook
    • 10
  • Carlos A. Garberoglio
    • 11
  • John T. Vetto
    • 12
  • Merrick I. Ross
    • 4
  • David Chu
    • 13
  • Vijay Trisal
    • 13
  • Harald Hoekstra
    • 14
  • Eric Whitman
    • 15
  • Harold J. Wanebo
    • 16
  • Daniel DeBonis
    • 17
  • Michael Vezeridis
    • 18
  • Aaron Chevinsky
    • 19
  • Mohammed Kashani-Sabet
    • 20
  • Yu Shyr
    • 2
  • Lynne Berry
    • 2
  • Zhiguo Zhao
    • 2
  • Seng-jaw Soong
    • 3
  • Stanley P. L. Leong
    • 20
  • for the Sentinel Lymph Node Working Group
  1. 1.Department of General Surgery, Division of Surgical Oncology, Blumenthal Cancer CenterCarolinas Medical CenterCharlotteUSA
  2. 2.Vanderbilt University School of MedicineNashvilleUSA
  3. 3.University of Alabama at BirminghamBirminghamUSA
  4. 4.University of Texas M. D. Anderson Cancer CenterHoustonUSA
  5. 5.Mayo ClinicScottsdaleUSA
  6. 6.John Wayne Cancer InstituteSanta MonicaUSA
  7. 7.St. Joseph HospitalOrangeUSA
  8. 8.Miller School of MedicineUniversity of MiamiMiamiUSA
  9. 9.University of KielKielGermany
  10. 10.MetroHealth Medical CenterClevelandUSA
  11. 11.Loma Linda University Medical CenterLoma LindaUSA
  12. 12.Oregon Health & Science UniversityPortlandUSA
  13. 13.City of Hope Medical CenterDuarteUSA
  14. 14.Groningen University Medical CenterGroningenThe Netherlands
  15. 15.Atlantic Melanoma CenterAtlantic HealthMorristownUSA
  16. 16.Roger Williams Medical CenterProvidenceUSA
  17. 17.University of Buenos AiresBuenos AiresArgentina
  18. 18.Rhode Island HospitalProvidenceUSA
  19. 19.Morristown Memorial HospitalMorristownUSA
  20. 20.California Pacific Medical Center and Research InstituteSan FranciscoUSA

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