Size of sentinel node metastases predicts other nodal disease and survival in malignant melanoma.
BACKGROUND
A positive sentinel lymph node (SLN) biopsy is an indication for completion lymph node dissection (CLND) in malignant melanoma; however, most CLNDs are negative. We hypothesized SLN metastatic size of < or =2 mm would predict CLND status and prognosis.


METHODS
We evaluated 80 consecutive patients undergoing CLND for positive SLNs over a 10-year period. Incidence of positive nonsentinel nodes and survival were compared for patients with SLN metastases < or =2 mm and >2 mm.


RESULTS
Of 504 patients undergoing SLN biopsy, 49 patients had SLN deposits < or =2 mm and a 6% incidence of positive CLNDs. Five-year survival was 85%, essentially the same as negative SLN biopsies. In contrast, 31 had SLN metastases >2 mm, a 45% incidence of addition disease at CLND, and 5-year survival of 47% (P < .0001).


CONCLUSIONS
An SLN metastatic cut point of 2 mm is an efficient predictor of CLND status and survival in malignant melanoma.
Pearlman
Nathan W
NW
Department of Surgery, University of Colorado Health Science, C311, University Hospital, 4200 E Ninth Avenue, Denver, CO 80262, USA. Nathan.Pearlman@uchsc.edu <Nathan.Pearlman@uchsc.edu>
McCarter
Martin D
MD
Frank
Matthew
M
Hurtubis
Cheryl
C
Merkow
Ryan P
RP
Franklin
Wilbur A
WA
Gonzalez
Rene
R
Lewis
Karl
K
Roaten
J Brent
JB
Robinson
William A
WA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*; D016019:Survival Analysis