BACKGROUND: Lymphatic mapping/sentinel lymphadenectomy (LM/SL) has become a routine part of our treatment algorithm for primary melanoma, yet its role in the management of thick (>or=4-mm) lesions is unknown. METHODS: One hundred twenty-one patients with thick primaries underwent LM/SL at our institute. Survival curves were constructed from Kaplan-Meier estimates and analyzed by Cox proportional hazards methods. RESULTS: Sixty-three percent of patients were men, median age 54 years. The primary tumor sites were trunk (46%), extremities (32%), and head and neck (21%). Primary thickness ranged from 4 to 15 mm (median, 6.0 mm). Forty-five percent of primary tumors were ulcerated. Thirty-five percent of patients had tumor-positive dissections. Median follow-up was 31 months. The overall 5-year survival was no different (P =.726) for ulcerated and nonulcerated lesions. There was no difference (P =.159) in overall survival after tumor-negative (60% +/- 7%) and tumor-positive (50% +/- 10%) dissections. The 5-year disease-free survival was significantly (P =.012) lower in patients with tumor-positive (34% +/- 9%) than tumor-negative (47% +/- 7%) dissections. CONCLUSIONS: Although LM/SL has become a popular technique for staging the regional lymph nodes in early-stage melanoma, our results suggest that sentinel node status is predictive of disease-free survival for thick primary tumors but is not yet reflective of overall survival. The role of LM/SL for patients with thick primary tumors is not clearly defined.
BACKGROUND: Lymphatic mapping/sentinel lymphadenectomy (LM/SL) has become a routine part of our treatment algorithm for primary melanoma, yet its role in the management of thick (>or=4-mm) lesions is unknown. METHODS: One hundred twenty-one patients with thick primaries underwent LM/SL at our institute. Survival curves were constructed from Kaplan-Meier estimates and analyzed by Cox proportional hazards methods. RESULTS: Sixty-three percent of patients were men, median age 54 years. The primary tumor sites were trunk (46%), extremities (32%), and head and neck (21%). Primary thickness ranged from 4 to 15 mm (median, 6.0 mm). Forty-five percent of primary tumors were ulcerated. Thirty-five percent of patients had tumor-positive dissections. Median follow-up was 31 months. The overall 5-year survival was no different (P =.726) for ulcerated and nonulcerated lesions. There was no difference (P =.159) in overall survival after tumor-negative (60% +/- 7%) and tumor-positive (50% +/- 10%) dissections. The 5-year disease-free survival was significantly (P =.012) lower in patients with tumor-positive (34% +/- 9%) than tumor-negative (47% +/- 7%) dissections. CONCLUSIONS: Although LM/SL has become a popular technique for staging the regional lymph nodes in early-stage melanoma, our results suggest that sentinel node status is predictive of disease-free survival for thick primary tumors but is not yet reflective of overall survival. The role of LM/SL for patients with thick primary tumors is not clearly defined.
Authors: Sandra L Wong; Charles M Balch; Patricia Hurley; Sanjiv S Agarwala; Timothy J Akhurst; Alistair Cochran; Janice N Cormier; Mark Gorman; Theodore Y Kim; Kelly M McMasters; R Dirk Noyes; Lynn M Schuchter; Matias E Valsecchi; Donald L Weaver; Gary H Lyman Journal: J Clin Oncol Date: 2012-07-09 Impact factor: 44.544
Authors: Maki Yamamoto; Kate J Fisher; Joyce Y Wong; Jonathan M Koscso; Monique A Konstantinovic; Nicholas Govsyeyev; Jane L Messina; Amod A Sarnaik; C Wayne Cruse; Ricardo J Gonzalez; Vernon K Sondak; Jonathan S Zager Journal: Cancer Date: 2015-02-11 Impact factor: 6.860
Authors: Juan Carlos Rodriguez Otero; Maria Susana Dagatti; Ramon Fernandez Bussy; Adriana Bergero; Mario Gorosito; Roberto Staffieri; Roberto Villavicencio; Stella Maris Batalles; Stella Maris Pezzotto Journal: World J Oncol Date: 2019-04-20
Authors: L Vermeeren; W M C Klop; M W M van den Brekel; A J M Balm; O E Nieweg; R A Valdés Olmos Journal: J Oncol Date: 2009-11-09 Impact factor: 4.375