Optimized assessment of sentinel lymph nodes for metastatic melanoma: implications for regional surgery and overall treatment planning.
Correct identification of the sentinel node (SN) and accurate evaluation of this node's tumor status constitute the most precise technique for staging clinically localized cutaneous melanoma. However, even if tumor is present in the SN (as in approximately 20% of patients), the remaining nodes in the basin are often tumor-free. We have found that the Breslow thickness of the primary, the relative area of tumor in the SN (with respect to the area of the SN), and the density of dendritic leukocytes in the SN paracortex not only can predict the likelihood of nonsentinel node metastases but also are correlated with likelihood of tumor recurrence and melanoma-specific survival. The most robust of these predictors is relative tumor area, and this may be used as the basis of practical predictive algorithms.
Cochran
Alistair J
AJ
Departments of Pathology and Laboratory Medicine and Surgery, University of California, Los Angeles School of Medicine, Los Angeles, California, USA. acochran@mednet.ucla.edu
Roberts
Alice
A
Wen
Duan-Ren
DR
Huang
Rong-Rong
RR
Itakura
Eijun
E
Luo
Frank
F
Binder
Scott W
SW
D000465:Algorithms; D004396:Coloring Agents; D003713:Dendritic Cells / Q000378:metabolism; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000473:pathology*; D008545:Melanoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery
D004396:Coloring Agents; D012394:Rosaniline Dyes; C025484:iso-sulfan blue