title: Size of sentinel node metastases predicts other nodal disease and survival in malignant melanoma.
abstract: 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.
authors.affiliation: 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>
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Pearlman
authors.forename: Martin D
authors.initials: MD
authors.lastname: McCarter
authors.forename: Matthew
authors.initials: M
authors.lastname: Frank
authors.forename: Cheryl
authors.initials: C
authors.lastname: Hurtubis
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Merkow
authors.forename: Wilbur A
authors.initials: WA
authors.lastname: Franklin
authors.forename: Rene
authors.initials: R
authors.lastname: Gonzalez
authors.forename: Karl
authors.initials: K
authors.lastname: Lewis
authors.forename: J Brent
authors.initials: JB
authors.lastname: Roaten
authors.forename: William A
authors.initials: WA
authors.lastname: Robinson
mesh_terms: 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