Predictors of sentinel lymph node positivity in thin melanoma using the National Cancer Database

Journal of the American Academy of Dermatology
Rosalynn R Z ConicBrian R Gastman

Abstract

Sentinel lymph node biopsy (SLNB) specimens are often obtained from patients for further staging after these patients have undergone melanoma excision. Limited data regarding predictors of SLNB positivity in thin melanoma are available. We sought to evaluate predictors of SLNB positivity in thin melanoma. Patients with cutaneous melanoma with a Breslow thickness ≤1.00 mm who received a SLNB were identified from the National Cancer Database between 2004 and 2014 (n = 9186). Predictors of SLNB positivity were analyzed using logistic regression. In a multivariate analysis, patients <60 years of age (P < .001) and Breslow thickness >0.8 mm (P = .03) were at increased risk for positive sentinel lymph node (SLN). Moreover, on multivariate analysis, the presence of dermal mitoses increased the odds of SLN positivity by 95% (odds ratio [OR] 1.95 [95% confidence interval {CI} 1.53-2.5], P < .001), ulceration by 63% (OR 1.63 [95% CI 1.21-2.18], P < .001), and Clark level IV to V by 48% (OR 1.48 [95% CI 1.19-1.85]). Patients without ulceration but with dermal mitoses had 92% (OR 1.92 [95% CI 1.5-2.48], P < .001) increased SLN positivity. Limited survival data are available. Younger age, a Breslow thickness >0.8 mm, the presence of dermal ...Continue Reading

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Citations

Jun 20, 2019·Cancer Medicine·Antonio Tejera-VaquerizoUNKNOWN SENTIMEL group
Jul 19, 2019·Journal of the European Academy of Dermatology and Venereology : JEADV·F S A de BeerM El Sharouni
Apr 9, 2020·Archives of Dermatological Research·Cristina FortesP Michelozzi
May 15, 2020·Annals of Surgical Oncology·Yun SongGiorgos C Karakousis
Aug 9, 2019·Annals of Surgical Oncology·Michael E EggerKelly M McMasters
Oct 20, 2020·Dermatologic Therapy·Esperanza Ramirez-MorenoRicardo Ruiz-Villaverde
Jul 28, 2020·The Journal of Surgical Research·Anna J SkochdopoleE Ramsay Camp
Mar 10, 2021·Archives of Dermatological Research·Khalaf KridinArnon D Cohen
Feb 23, 2021·Laryngoscope Investigative Otolaryngology·Elizabeth KimSamir S Khariwala
May 16, 2020·Annals of Surgical Oncology·Yun SongGiorgos C Karakousis
Jun 3, 2020·Surgical Oncology Clinics of North America·Adrienne B ShannonGiorgos C Karakousis
Jul 24, 2021·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Titus J BrinkerJochen S Utikal

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