Predictors of positive sentinel lymph node in thin melanoma

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• 作者：David V. Yonick M.D.^a ; Rana M. Ballo M.D.^a ; Estelle Kahn M.D.^a ; ; Madhu Dahiya M.D.^b ; Katherine Yao M.D.^a ; Constantine Godellas M.D.^a ; Margo Shoup M.D.^a ; Gerard V. Aranha M.D.^a ; ^{garanha@lumc.edu}
• 关键词：Melanoma ; Thin melanoma ; Sentinel lymph node ; Sentinel lymph node biopsy
• 刊名：The American Journal of Surgery
• 出版年：2011
• 出版时间：March 2011
• 年：2011
• 卷：201
• 期：3
• 页码：324-328
• 全文大小：144 K

文摘

lass=""h4"">Background

The treatment of thin melanoma (Breslow thickness <1.0 mm) may include sentinel lymph node (SLN) biopsy (SLNB). The validity of SLNB for thin melanoma remains widely debated. The purpose of this study was to elucidate pathologic factors that are predictive of SLN positivity.

lass=""h4"">Methods

A retrospective analysis of a prospective database revealed 1,199 patients diagnosed with primary cutaneous melanoma. Multiple logistic regression was used to determine an association between pathologic factors and SLN positivity.

lass=""h4"">Results

Thin melanomas were identified in 469 patients (39 % ). Of these, 147 patients (31 % ) underwent SLNB. Positive SLNs were found in 16 patients (11 % ). Multiple logistic regression demonstrated that both ulceration (odds ratio, 5.27; P = .047) and thickness (odds ratio, 46.69; P = .022) were associated with SLN positivity.

lass=""h4"">Conclusions

Patients with thin melanomas >.75 mm and/or ulceration should be considered for SLNB.