title: Clinical significance of the RT-PCR positive sentinel node in melanoma.
abstract: BACKGROUND
  The clinical relevance of RT-PCR positivity for melanoma markers in the sentinel node remains controversial. Our purpose was to determine whether patients with a histologically negative but RT-PCR positive node were at an increased risk for recurrence than their RT-PCR negative counterparts.
  
  
  METHODS
  Thirty-nine adult patients underwent sentinel node biopsies for melanoma between 1998 and 2000. Each sentinel node was bivalved. Half was serially sectioned and examined by routine hematoxylin and eosin (H&E) and immunohistochemistry (IHC; S100, HMB-45, melanA, and tyrosinase). The other half was analyzed by a nested RT-PCR assay for tyrosinase.
  
  
  RESULTS
  Patients were followed for recurrence with a mean follow-up of 71.1 months. The odds ratio of recurrence for RT-PCR positive versus RT-PCR negative patients was 1.39 (0.34, 5.62; p = 0.73). Within the histology negative subgroups, the risk of recurrence in the RT-PCR positive group (26.7%) was not significantly different from the risk of recurrence in the RT-PCR negative group (22.2%) (p = 0.33 chi-squared). RT-PCR of the sentinel node was not a predictor for recurrence on multivariate analysis (p = 0.65).
  
  
  CONCLUSIONS
  Sentinel node RT-PCR positivity did not risk stratify histologically negative melanoma patients beyond routine pathologic examination in this series.
authors.affiliation: Division of Plastic Surgery, University of Western Ontario, London, Ontario, Canada. ctemple4@uwo.ca
authors.forename: C L F
authors.initials: CL
authors.lastname: Temple
authors.forename: L J
authors.initials: LJ
authors.lastname: Snell
authors.forename: S M
authors.initials: SM
authors.lastname: Power
authors.forename: J R
authors.initials: JR
authors.lastname: Parfitt
authors.forename: C
authors.initials: C
authors.lastname: Scilley
authors.forename: C J
authors.initials: CJ
authors.lastname: Engel
authors.forename: D
authors.initials: D
authors.lastname: Shum
authors.forename: S
authors.initials: S
authors.lastname: Chakrabarti
authors.forename: M G
authors.initials: MG
authors.lastname: Joseph
authors.forename: R C
authors.initials: RC
authors.lastname: Lohmann
authors.forename: P
authors.initials: P
authors.lastname: Ainsworth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology*; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*