BACKGROUND: Most melanoma patients with a positive sentinel lymph node dissection (SLND) undergo a completion lymph node dissection (CLND) that does not yield additional positive nonsentinel lymph nodes (NSLN). This study was designed to determine if NSLN status can be predicted using patient, primary tumor, and sentinel lymph node (SLN) characteristics. METHODS: The study population includes melanoma patients who had a positive SLND and subsequently underwent CLND retrieved from our prospective institutional melanoma database. The primary tumor and SLN pathologies were prospectively determined. An Size/Ulceration (SU) score was derived by assigning 1 point for primary tumor ulceration and 1 point for SLN tumor size >2 mm. RESULTS: Ninety-eight patients had a positive SLND and underwent CLND. Sixteen of these patients had a positive NSLN. On univariate analysis, primary tumor characteristics (thickness, ulceration, no regression), SLN metastasis characteristics (size >2 mm, location nonsubcapsular), and SU score were all significantly associated with positive NSLN status. However, on multivariate analysis, only the SU score was a significant independent predictor of NSLN status. No patient with an SU score of 0 had a positive NSLN. CONCLUSIONS: The SU score is predictive of NSLN status in patients with a positive SLND. Patients with an SU score of 0 are very unlikely to have positive NSLNs at CLND.
BACKGROUND: Most melanomapatients with a positive sentinel lymph node dissection (SLND) undergo a completion lymph node dissection (CLND) that does not yield additional positive nonsentinel lymph nodes (NSLN). This study was designed to determine if NSLN status can be predicted using patient, primary tumor, and sentinel lymph node (SLN) characteristics. METHODS: The study population includes melanomapatients who had a positive SLND and subsequently underwent CLND retrieved from our prospective institutional melanoma database. The primary tumor and SLN pathologies were prospectively determined. An Size/Ulceration (SU) score was derived by assigning 1 point for primary tumor ulceration and 1 point for SLN tumor size >2 mm. RESULTS: Ninety-eight patients had a positive SLND and underwent CLND. Sixteen of these patients had a positive NSLN. On univariate analysis, primary tumor characteristics (thickness, ulceration, no regression), SLN metastasis characteristics (size >2 mm, location nonsubcapsular), and SU score were all significantly associated with positive NSLN status. However, on multivariate analysis, only the SU score was a significant independent predictor of NSLN status. No patient with an SU score of 0 had a positive NSLN. CONCLUSIONS: The SU score is predictive of NSLN status in patients with a positive SLND. Patients with an SU score of 0 are very unlikely to have positive NSLNs at CLND.
Authors: Ji-Bin Liu; Daniel A Merton; Adam C Berger; Flemming Forsberg; Agnieszka Witkiewicz; Hongjia Zhao; John R Eisenbrey; Traci B Fox; Barry B Goldberg Journal: J Ultrasound Med Date: 2014-06 Impact factor: 2.153
Authors: David Y Lee; Briana J Lau; Kelly T Huynh; Devin C Flaherty; Ji-Hey Lee; Stacey L Stern; Steve J O'Day; Leland J Foshag; Mark B Faries Journal: J Am Coll Surg Date: 2016-01-29 Impact factor: 6.113
Authors: Stanley P L Leong; Martin C Mihm; George F Murphy; Dave S B Hoon; Mohammed Kashani-Sabet; Sanjiv S Agarwala; Jonathan S Zager; Axel Hauschild; Vernon K Sondak; Valerie Guild; John M Kirkwood Journal: Clin Exp Metastasis Date: 2012-08-15 Impact factor: 5.150
Authors: Rajmohan Murali; Alistair J Cochran; Martin G Cook; Joseph D Hillman; Rooshdiya Z Karim; Marc Moncrieff; Hans Starz; John F Thompson; Richard A Scolyer Journal: Cancer Date: 2009-11-01 Impact factor: 6.860
Authors: Jeffrey E Gershenwald; Robert H I Andtbacka; Victor G Prieto; Marcella M Johnson; A Hafeez Diwan; Jeffrey E Lee; Paul F Mansfield; Janice N Cormier; Christopher W Schacherer; Merrick I Ross Journal: J Clin Oncol Date: 2008-07-07 Impact factor: 44.544