BACKGROUND: The amount of metastatic disease in the sentinel lymph node (SLN) is examined as a prognostic factor in malignant melanoma. METHODS: SLN mapping was performed on 592 patients with stage I and II malignant melanoma from March 1, 1994, through December 31, 1999. One hundred four patients were found to have 134 sentinel SLNs containing metastatic melanoma. The slides were reviewed, and the size of the metastatic melanoma in each SLN was measured. The size of the metastatic deposit was defined as macrometastasis (>2 mm), micrometastasis (< or =2 mm), a cluster of cells (10-30 grouped cells) in the subcapsular space or interfollicular zone, or isolated melanoma cells (1 to > or =20 individual cells) in subcapsular sinuses. RESULTS: The number of metastases in each SLN was isolated melanoma cells, n = 5 (3.7%); cluster of cells, n = 35 (26.1%); < or =2 mm, n = 45 (33.6%); and >2 mm, n = 49 (36.7%). Seventy-nine patients (76%) had a single positive SLN. The size of the largest nodal metastasis was used to stratify patients with multiple positive SLNs. The overall 3-year survival for patients with SLN micrometastases was 90%, versus 58% for patients with SLN macrometastases (P =.004). CONCLUSIONS: The amount of metastatic melanoma in an SLN is an independent predictor of survival. Patients with SLN metastatic deposits >2 mm in diameter have significantly decreased survival.
BACKGROUND: The amount of metastatic disease in the sentinel lymph node (SLN) is examined as a prognostic factor in malignant melanoma. METHODS: SLN mapping was performed on 592 patients with stage I and II malignant melanoma from March 1, 1994, through December 31, 1999. One hundred four patients were found to have 134 sentinel SLNs containing metastatic melanoma. The slides were reviewed, and the size of the metastatic melanoma in each SLN was measured. The size of the metastatic deposit was defined as macrometastasis (>2 mm), micrometastasis (< or =2 mm), a cluster of cells (10-30 grouped cells) in the subcapsular space or interfollicular zone, or isolated melanoma cells (1 to > or =20 individual cells) in subcapsular sinuses. RESULTS: The number of metastases in each SLN was isolated melanoma cells, n = 5 (3.7%); cluster of cells, n = 35 (26.1%); < or =2 mm, n = 45 (33.6%); and >2 mm, n = 49 (36.7%). Seventy-nine patients (76%) had a single positive SLN. The size of the largest nodal metastasis was used to stratify patients with multiple positive SLNs. The overall 3-year survival for patients with SLN micrometastases was 90%, versus 58% for patients with SLN macrometastases (P =.004). CONCLUSIONS: The amount of metastatic melanoma in an SLN is an independent predictor of survival. Patients with SLN metastatic deposits >2 mm in diameter have significantly decreased survival.
Authors: Johanna Soikkeli; Piotr Podlasz; Miao Yin; Pirjo Nummela; Tiina Jahkola; Susanna Virolainen; Leena Krogerus; Päivi Heikkilä; Karl von Smitten; Olli Saksela; Erkki Hölttä Journal: Am J Pathol Date: 2010-05-20 Impact factor: 4.307
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: Scott R Dalton; Pedram Gerami; Nicholas A Kolaitis; Susan Charzan; Rob Werling; Philip E LeBoit; Boris C Bastian Journal: Am J Surg Pathol Date: 2010-02 Impact factor: 6.394