title: [Tumour regression is not predictive for higher risk of sentinel node involvement in thin melanomas (Breslow thickness < or = 1 mm)].
abstract: BACKGROUND
  Thin melanomas (Breslow thickness < or = 1 mm) are considered highly curable. The aim of this study was to evaluate the correlation between histological tumour regression and sentinel lymph node (SLN) involvement in thin melanomas.
  
  
  METHODS
  This was a retrospective single-centre study of 34 patients with thin melanomas undergoing SLN biopsy between April 1998 and January 2005.
  
  
  RESULTS
  The study included 14 women and 20 men of mean age 56.3 years. Melanomas were located on the neck (n=3), soles (n=4), trunk (n=13) and extremities (n=14). Pathological examination showed 25 SSM, four acral lentiginous melanomas, three in situ melanomas, one nodular melanoma and one unclassified melanoma with a mean Breslow thickness of 0.57 mm. Histological tumour regression was observed in 26 over 34 cases and ulceration was found in one case. Clark levels were as follows: I (n=3), II (n=20), III (n=9), IV (n=2). Growth phase was available in 15 cases (seven radial and eight vertical). Mitotic rates, available in 24 cases, were: 0 (n=9), 1 (n=11), 2 (n=2), 3 (n=1), 6 (n=1). One patient with histological tumour regression (2.9% of cases and 3.8% of cases with regressing tumours) had a metastatic SLN. One patient negative for SLN had a lung relapse and died of the disease. Mean follow-up was 26.2 months.
  
  
  CONCLUSIONS
  The results of the present study and the analysis of the literature show that histological regression of the primary tumour does not seem predictive of higher risk of SLN involvement in thin melanomas. This suggests that screening for SLN is not indicated in thin melanomas, even those with histological regression.
authors.affiliation: Service de dermatologie, hôpital Cochin, AP-HP, université Paris-5, pavillon Tarnier, 89, rue d'Assas, 75006 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Kramkimel
authors.forename: E
authors.initials: E
authors.lastname: Maubec
authors.forename: F
authors.initials: F
authors.lastname: Boitier
authors.forename: A
authors.initials: A
authors.lastname: Cavalcanti
authors.forename: M
authors.initials: M
authors.lastname: Beldi
authors.forename: G
authors.initials: G
authors.lastname: Mamelle
authors.forename: F
authors.initials: F
authors.lastname: Kolb
authors.forename: P
authors.initials: P
authors.lastname: Duvillard
authors.forename: M-F
authors.initials: MF
authors.lastname: Avril
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000648:ultrastructure; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000648:ultrastructure*; D008875:Middle Aged; D008940:Mitotic Index; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000648:ultrastructure*; D047368:Tumor Burden; D019564:Unnecessary Procedures