PURPOSE: To evaluate the prognostic significance of sentinel node biopsy in the management of stage IB and II melanoma patients, and to evaluate the status of nonsentinel nodes as a "second step key factor" to assess the prognosis of these patients. PATIENTS AND METHODS: We conducted an analysis of data collected in a prospective database. RESULTS: From February 1994 to June 2005, 1,108 consecutive patients with stage IB and II melanoma were submitted to sentinel node biopsy; 176 patients (15.9%) had occult node metastases. The frequency of positive nodes increased with increasing Breslow's thickness. The largest diameter of metastatic foci and their localization within the lymph node were associated with the risk of nonsentinel node metastases only. The 5-year survival of patients with positive sentinel nodes was 81.4% in patients with one positive node and 39.6% in patients with two positive nodes (P = .056). Multivariate analysis indicated that status of sentinel nodes is a key factor and that sex and Breslow's thickness maintain statistically significant relevance. Ulceration, which was associated with survival when considered as single factor (P < .001) had no impact on survival in the multivariate analysis (P = .10). To evaluate the relevance of metastases to nonsentinel nodes, we identified four groups of patients. CONCLUSION: Evaluation of the sentinel node is a useful procedure to identify patients to be submitted for complete lymph node dissection. The procedure makes it possible to assess the best prognosis of patients.
PURPOSE: To evaluate the prognostic significance of sentinel node biopsy in the management of stage IB and II melanomapatients, and to evaluate the status of nonsentinel nodes as a "second step key factor" to assess the prognosis of these patients. PATIENTS AND METHODS: We conducted an analysis of data collected in a prospective database. RESULTS: From February 1994 to June 2005, 1,108 consecutive patients with stage IB and II melanoma were submitted to sentinel node biopsy; 176 patients (15.9%) had occult node metastases. The frequency of positive nodes increased with increasing Breslow's thickness. The largest diameter of metastatic foci and their localization within the lymph node were associated with the risk of nonsentinel node metastases only. The 5-year survival of patients with positive sentinel nodes was 81.4% in patients with one positive node and 39.6% in patients with two positive nodes (P = .056). Multivariate analysis indicated that status of sentinel nodes is a key factor and that sex and Breslow's thickness maintain statistically significant relevance. Ulceration, which was associated with survival when considered as single factor (P < .001) had no impact on survival in the multivariate analysis (P = .10). To evaluate the relevance of metastases to nonsentinel nodes, we identified four groups of patients. CONCLUSION: Evaluation of the sentinel node is a useful procedure to identify patients to be submitted for complete lymph node dissection. The procedure makes it possible to assess the best prognosis of patients.
Authors: Annette H Chakera; Birger Hesse; Zeynep Burak; James R Ballinger; Allan Britten; Corrado Caracò; Alistair J Cochran; Martin G Cook; Krzysztof T Drzewiecki; Richard Essner; Einat Even-Sapir; Alexander M M Eggermont; Tanja Gmeiner Stopar; Christian Ingvar; Martin C Mihm; Stanley W McCarthy; Nicola Mozzillo; Omgo E Nieweg; Richard A Scolyer; Hans Starz; John F Thompson; Giuseppe Trifirò; Giuseppe Viale; Sergi Vidal-Sicart; Roger Uren; Wendy Waddington; Arturo Chiti; Alain Spatz; Alessandro Testori Journal: Eur J Nucl Med Mol Imaging Date: 2009-10 Impact factor: 9.236
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Authors: Richard L White; 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 Journal: Ann Surg Oncol Date: 2011-06-07 Impact factor: 5.344
Authors: Anna M Leung; Donald L Morton; Junko Ozao-Choy; Danielle M Hari; Myung Shin-Sim; Andrew L Difronzo; Mark B Faries Journal: JAMA Surg Date: 2013-09 Impact factor: 14.766
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
Authors: Melanie A Warycha; Jan Zakrzewski; Quanhong Ni; Richard L Shapiro; Russell S Berman; Anna C Pavlick; David Polsky; Madhu Mazumdar; Iman Osman Journal: Cancer Date: 2009-02-15 Impact factor: 6.860