The prognostic significance of nonsentinel lymph node metastasis in melanoma

Annals of Surgical Oncology
Russell E BrownCharles R Scoggins

Abstract

We hypothesized that metastasis beyond the sentinel lymph nodes (SLN) to the nonsentinel nodes (NSN) is an important predictor of survival. Analysis was performed of a prospective multi-institutional study that included patients with melanoma ≥ 1.0 mm in Breslow thickness. All patients underwent SLN biopsy; completion lymphadenectomy was performed for all SLN metastases. Disease-free survival (DFS) and overall survival (OS) were computed by Kaplan-Meier analysis; univariate and multivariate analyses were performed to identify factors associated with differences in survival among groups. A total of 2335 patients were analyzed over a median follow-up of 68 months. We compared 3 groups: SLN negative (n = 1988), SLN-only positive (n = 296), and both SLN and NSN positive (n = 51). The 5-year DFS rates were 85.5, 64.8, and 42.6% for groups 1, 2, and 3, respectively (P < 0.001). The 5-year OS rates were 85.5, 64.9, and 49.4%, respectively (P < 0.001). On univariate analysis, predictors of decreased OS included: SLN metastasis, NSN metastasis, increased total number of positive LN, increased ratio of positive LN to total LN, increased age, male gender, increased Breslow thickness, presence of ulceration, Clark level ≥ IV, and axial pri...Continue Reading

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Citations

Feb 5, 2014·Journal of the American College of Surgeons·Michael E EggerKelly M McMasters
Oct 16, 2013·American Journal of Surgery·Michael E EggerKelly M McMasters
Aug 29, 2012·Surgery·Michael E EggerKelly M McMasters
Jan 26, 2013·International Journal of Dermatology·Josefine BegerUwe Wollina
Oct 16, 2014·Annals of Surgical Oncology·Pasquali SandroRossi Carlo Riccardo
Feb 12, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Sandro PasqualiCarlo Riccardo Rossi
Jan 1, 2011·Cancers·Xuesong WuSam T Hwang
Feb 13, 2018·Melanoma Research·Alessandro A TestoriUNKNOWN European Organization for Research and Treatment of Cancer (EORTC) Melanoma Group
Mar 8, 2018·Wiener medizinische Wochenschrift·Uwe Wollina, Piotr Brzezinski
Sep 19, 2019·Annals of Surgical Oncology·Michael E EggerKelly M McMasters
Aug 9, 2016·Annals of Surgical Oncology·Mark A HealySandra L Wong
Oct 5, 2018·Annals of Surgical Oncology·Tina J HiekenSandra L Wong
Dec 29, 2020·The Journal of Surgical Research·Arezoo RajaeeMichael E Egger

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