title: Factors predictive of the status of sentinel lymph nodes in melanoma patients from a large multicenter database.
abstract: BACKGROUND
  Numerous predictive factors for cutaneous melanoma metastases to sentinel lymph nodes have been identified; however, few have been found to be reproducibly significant. This study investigated the significance of factors for predicting regional nodal disease in cutaneous melanoma using a large multicenter database.
  
  
  METHODS
  Seventeen institutions submitted retrospective and prospective data on 3463 patients undergoing sentinel lymph node (SLN) biopsy for primary melanoma. Multiple demographic and tumor factors were analyzed for correlation with a positive SLN. Univariate and multivariate statistical analyses were performed.
  
  
  RESULTS
  Of 3445 analyzable patients, 561 (16.3%) had a positive SLN biopsy. In multivariate analysis of 1526 patients with complete records for 10 variables, increasing Breslow thickness, lymphovascular invasion, ulceration, younger age, the absence of regression, and tumor location on the trunk were statistically significant predictors of a positive SLN.
  
  
  CONCLUSIONS
  These results confirm the predictive significance of the well-established variables of Breslow thickness, ulceration, age, and location, as well as consistently reported but less well-established variables such as lymphovascular invasion. In addition, the presence of regression was associated with a lower likelihood of a positive SLN. Consideration of multiple tumor parameters should influence the decision for SLN biopsy and the estimation of nodal metastatic disease risk.
authors.affiliation: Department of General Surgery, Division of Surgical Oncology, Blumenthal Cancer Center, Carolinas Medical Center, Charlotte, NC, USA. Richard.white@carolinashealthcare.org
authors.forename: Richard L
authors.initials: RL
authors.lastname: White
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Ayers
authors.forename: Virginia H
authors.initials: VH
authors.lastname: Stell
authors.forename: Shouluan
authors.initials: S
authors.lastname: Ding
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Gershenwald
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Salo
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
authors.forename: Richard
authors.initials: R
authors.lastname: Essner
authors.forename: Mark
authors.initials: M
authors.lastname: Faries
authors.forename: Kim James
authors.initials: KJ
authors.lastname: Charney
authors.forename: Eli
authors.initials: E
authors.lastname: Avisar
authors.forename: Axel
authors.initials: A
authors.lastname: Hauschild
authors.forename: Friederike
authors.initials: F
authors.lastname: Egberts
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Averbook
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Garberoglio
authors.forename: John T
authors.initials: JT
authors.lastname: Vetto
authors.forename: Merrick I
authors.initials: MI
authors.lastname: Ross
authors.forename: David
authors.initials: D
authors.lastname: Chu
authors.forename: Vijay
authors.initials: V
authors.lastname: Trisal
authors.forename: Harald
authors.initials: H
authors.lastname: Hoekstra
authors.forename: Eric
authors.initials: E
authors.lastname: Whitman
authors.forename: Harold J
authors.initials: HJ
authors.lastname: Wanebo
authors.forename: Daniel
authors.initials: D
authors.lastname: Debonis
authors.forename: Michael
authors.initials: M
authors.lastname: Vezeridis
authors.forename: Aaron
authors.initials: A
authors.lastname: Chevinsky
authors.forename: Mohammed
authors.initials: M
authors.lastname: Kashani-Sabet
authors.forename: Yu
authors.initials: Y
authors.lastname: Shyr
authors.forename: Lynne
authors.initials: L
authors.lastname: Berry
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: Zhao
authors.forename: Seng-Jaw
authors.initials: SJ
authors.lastname: Soong
authors.forename: Stanley P L
authors.initials: SP
authors.lastname: Leong
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy