Related Experiment Video
Updated: Jul 11, 2026
Quantification of Tumor Cell Adhesion in Lymph Node Cryosections
Published on: February 9, 2020
Isolated tumor cells in the sentinel node affect long-term prognosis of patients with melanoma
Randall P Scheri1, Richard Essner, Roderick R Turner
1Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA. essner@jwci.org
Background:
The clinical significance of isolated tumor cells (ITCs) in the melanoma-draining sentinel nodes (SNs) is unclear.
Methods:
Records of patients who underwent SN biopsy (SNB) for stage I/II melanoma at our institute between 1991 and 2003 were reviewed to identify patients whose SNs were tumor-free or contained only ITC (
Results:
Of 1,382 patients who underwent SNB, 1,168 (85%) had tumor-free SNs; among the 214 remaining patients with tumor-positive SNs, 57 had metastases limited to ITC. Completion lymphadenectomy (CLND) was performed in 52 of 57 patients: six (12%) had metastases in nonsentinel nodes (NSNs). At a median follow-up of 57 months, 5-year and 10-year MSS was significantly higher (P = .02) for the 1168 patients with tumor-negative SNs (94 +/- 1% and 87 +/- 2%, respectively) than the 57 patients with ITC-positive SNs (89 +/- 4% and 80 +/- 7%, respectively). Multivariate analysis identified ITC (P = .002), Breslow's thickness (P < .0001), ulceration (P < .0001), and primary site (P = .04) as significant for MSS.
Conclusion:
Patients with ITC in SNs have a significantly higher risk of melanoma-specific death than those with tumor-negative SNs. The 12% incidence of nonsentinel node metastasis is similar to rates reported for patients with more extensive SN involvement. Patients with ITC should be considered for CLND.
