title: Importance of sentinel lymph node biopsy in patients with thin melanoma.
abstract: OBJECTIVE
  The status of the sentinel node (SN) confers important prognostic information for patients with thin melanoma.
  
  
  METHODS
  We queried our melanoma database to identify patients undergoing sentinel lymph node biopsy for thin (< or =1.00-mm) cutaneous melanoma at a tertiary care cancer institute. Slides of tumor-positive SNs were reviewed by a melanoma pathologist to confirm nodal status and intranodal tumor burden, defined as isolated tumor cells, micrometastasis, or macrometastasis (< or =0.20, 0.21-2.00, or >2.00 mm, respectively). Nodal status was correlated with patient age and primary tumor depth (< or = 0.25, 0.26-0.50, 0.51-0.75, or 0.76-1.00 mm). Survival was determined by log-rank test.
  
  
  METHODS
  Disease-free and melanoma-specific survival.
  
  
  RESULTS
  Of 1592 patients who underwent sentinel lymph node biopsy from 1991 to 2004, 631 (40%) had thin melanomas; 31 of the 631 patients (5%) had a tumor-positive SN. At a median follow-up of 57 months for the 631 patients, the mean (SD) 10-year rate of disease-free survival was 96% (1%) vs 54% (10%) for patients with tumor-negative vs tumor-positive SNs, respectively (P < .001); the mean (SD) 10-year rate of melanoma-specific survival was 98% (1%) vs 83% (8%), respectively (P < .001). Tumor-positive SNs were more common in patients aged 50 years and younger (P = .04). The SN status maintained importance on multivariate analysis for both disease-free survival (P < .001) and melanoma-specific survival (P < .001).
  
  
  CONCLUSIONS
  The status of the SN is significantly linked to survival in patients with thin melanoma. Therefore, sentinel lymph node biopsy should be considered to obtain complete prognostic information.
authors.affiliation: Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California 90404, USA.
authors.forename: Byron E
authors.initials: BE
authors.lastname: Wright
authors.forename: Randall P
authors.initials: RP
authors.lastname: Scheri
authors.forename: Xing
authors.initials: X
authors.lastname: Ye
authors.forename: Mark B
authors.initials: MB
authors.lastname: Faries
authors.forename: Roderick R
authors.initials: RR
authors.lastname: Turner
authors.forename: Richard
authors.initials: R
authors.lastname: Essner
authors.forename: Donald L
authors.initials: DL
authors.lastname: Morton
mesh_terms: D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology*
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