title: Impact of multiple lymphatic channel drainage to a single nodal basin on outcomes in melanoma.
abstract: OBJECTIVE
  To determine the impact of multiple lymphatic channels (MLCs) on outcome in melanoma.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Academic tertiary care center.
  
  
  METHODS
  Of 1198 consecutive selective sentinel lymphadenectomies performed from 1995 to 2000 for primary invasive melanoma, 502 patients were identified with extremity or truncal melanoma that drained to a single nodal basin. Three cohorts were formed based on lymphatic channels (none, single, and multiple). Tumors with drainage to multiple nodal basins as well as all head and neck tumors were excluded.
  
  
  METHODS
  Multiple variables, including patterns of lymphatic drainage, were analyzed for impact on disease-free and overall survival.
  
  
  RESULTS
  Demographics were similar among groups, with a median follow-up of 5.6 years. Univariate analysis revealed MLCs as an independent risk factor for both disease-free (P = .04) and overall survival (P = .003). Multivariate analysis confirmed that tumor depth, sentinel lymph node status, and MLCs were risk factors for both disease-free and overall survival. Kaplan-Meier analysis showed worse survival in the MLCs group.
  
  
  CONCLUSIONS
  Our study reveals that MLCs are an independent risk factor for recurrence and mortality in melanoma. Multiple lymphatic channels may facilitate the process of metastasis.
authors: Department of Surgery, UCSF, San Francisco, CA 94115, USA.
authors: James K
authors: JK
authors: Wall
authors: Marilyn
authors: M
authors: Florero
authors: Neil A
authors: NA
authors: Accortt
authors: Robert
authors: R
authors: Allen
authors: Mohamed
authors: M
authors: Kashani-Sabet
authors: Eugene
authors: E
authors: Morita
authors: Stanley P L
authors: SP
authors: Leong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D035002:Lower Extremity; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D013909:Thorax; D016896:Treatment Outcome; D034941:Upper Extremity