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Sentinel lymph node mapping for thick (>or=4-mm) melanoma: should we be doing it?
Grant W Carlson1, Douglas R Murray, Andrea Hestley
1Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USA. grant_carlson@emory.org
Annals of Surgical Oncology
|May 8, 2003
Summary
Sentinel lymph node (SLN) biopsy is a strong predictor of survival in patients with thick melanomas. Routine SLN mapping is recommended for these patients to assess prognosis and guide treatment.
Area of Science:
- Oncology
- Surgical Pathology
- Dermatology
Background:
- Thick melanomas (>=4mm) are associated with a high risk of metastasis.
- The utility of sentinel lymph node (SLN) biopsy for thick melanomas has been debated.
Purpose of the Study:
- To evaluate the prognostic significance of SLN biopsy in patients with thick primary melanomas.
- To determine if SLN status impacts overall survival.
Main Methods:
- Retrospective review of 114 patients who underwent SLN mapping and biopsy.
- Analysis of clinicopathologic features and survival data using Kaplan-Meier and Cox regression models.
Main Results:
- 32.5% of patients had a positive SLN biopsy.
- 3-year survival was 82% for SLN-negative vs. 57% for SLN-positive patients (P=.006).
- SLN status and tumor ulceration were independent predictors of survival.
Conclusions:
- Pathologic SLN status is a significant independent prognostic factor for survival in thick melanoma.
- Routine SLN mapping should be performed for patients with thick melanomas.