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Sentinel node location in trunk and extremity melanomas: uncommon or multiple lymph drainage does not affect survival
Daniela Gordon1, Karin E Smedby, Inkeri Schultz
1Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden, daniela.gordon@ki.se.
Annals of Surgical Oncology
|May 29, 2014
Summary
Cutaneous melanoma on the trunk has a worse prognosis, often linked to multiple sentinel lymph node locations. However, this study found that multiple or uncommon sentinel node locations do not explain the poorer survival outcomes for trunk melanomas.
Area of Science:
- Oncology
- Surgical Pathology
- Dermatology
Background:
- Cutaneous melanoma (CM) on the trunk is associated with a poorer prognosis compared to CM on extremities.
- Multiple or uncommon sentinel lymph node locations (SNLs) are hypothesized reasons for this disparity.
Purpose of the Study:
- To investigate the association between trunk CM and sentinel lymph node locations.
- To determine if multiple or uncommon SNLs contribute to the worse prognosis of trunk CM.
Main Methods:
- Retrospective analysis of 859 patients with trunk or extremity CM who underwent sentinel node biopsy.
- Logistic regression used to analyze SNL distribution; multivariable Cox regression used to assess survival.
- Data collected from Swedish healthcare regions (2000-2008).
Main Results:
- Trunk CM showed a significantly higher rate of multiple SNLs (31% vs. 7%) compared to extremity CM.
- No significant difference in the frequency of uncommon SNLs between trunk and extremity CM.
- Trunk CM remained associated with an increased risk of melanoma-specific death, particularly on the upper back, independent of SNL characteristics.
Conclusions:
- Trunk melanomas exhibit more complex lymphatic drainage patterns, indicated by a higher frequency of multiple SNLs.
- The poorer prognosis associated with trunk CM cannot be attributed to an increased incidence of multiple or uncommon sentinel lymph node locations.
