title: Clinical and dermoscopic criteria related to melanoma sentinel lymph node positivity.
abstract: BACKGROUND
  The early detection of lymph node metastases may have important prognostic and therapeutic implications in melanoma patients. The purpose of this study was to investigate whether specific clinical and/or dermoscopic features could be "in vivo" predictors of sentinel lymph node (SLN) positivity in melanomas >1 mm thick.
  
  
  METHODS
  Five Italian centres (Istituto Dermopatico dell'Immacolata, IDI, Rome; Skin Cancer Unit, Oncologia Dermatologica, CPO, Ravenna; Istituto Europeo Oncologico, Milan; Centro di Riferimento Oncologico, Aviano; Istituto Nazionale Tumori, Naples) carried out a blind retrospective study on 508 melanomas observed from January 1994 to December 2002. The clinical and dermoscopic features of 78 melanomas >1 mm thick with the SLN biopsied were reviewed.
  
  
  RESULTS
  The tumour palpability was the only factor correlated to SLN positivity in melanomas >1 mm thick. Palpability was found in 46.2% of nodal positive melanomas and in 18.5% of nodal negative melanomas (p=0.03). The patients with palpable melanomas showed a higher risk of nodal metastasis (OR=3.8). Dermoscopy failed to recognize predictive criteria for SLN positivity. Some clinical and dermoscopic features, although not statistically significant, showed interesting differences between nodal-negative and nodal-positive melanomas.
  
  
  CONCLUSIONS
  Melanoma palpability may suggest the presence of nodal metastasis in >1 mm thick tumours.
authors: Istituto Dermopatico dell'Immacolata, IRCCS, Roma, Italy. g.pagnanelli@idi.it
authors: Gianluca
authors: G
authors: Pagnanelli
authors: Riccardo
authors: R
authors: Bono
authors: Maria A
authors: MA
authors: Pizzichetta
authors: Renato
authors: R
authors: Talamini
authors: Paolo A
authors: PA
authors: Ascierto
authors: Alessandro
authors: A
authors: Testori
authors: Ignazio
authors: I
authors: Stanganelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046169:Dermoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods