Multiple lymphatic basin drainage from cutaneous melanoma as a prognostic factor.
BACKGROUND
There is some controversy in the literature regarding the possible prognostic value of cases of multiple lymphatic basin drainage (MLBD). The purpose of this work was to study the differences in prognosis depending on whether there is MLBD from primary cutaneous melanoma.


METHODS
We conducted a cohort analysis from a prospective database, and 112 consecutive patients with cutaneous melanoma were included. Sentinel lymph node biopsy (SLNB) was done in all of them. MLBD was defined as the occurrence of two or more different nodal basins from the same lesion. The demographic and clinical data for cases with a single nodal drainage basin and MLBD were statistically compared using Fisher's exact test, the χ(2) test, or Mann-Whitney's test according to the type of variables studied. Multivariate analysis also was performed on the disease-free survival rate using logistic regression analysis. The distribution of disease-free survival was determined using a Cox proportional risk model.


RESULTS
Only gender (27% men and 8% women; P = 0.01) and the localization of the primary tumor in the trunk (P < 0.001) were associated with the presence of MLBD. It also was observed that the cases with a high Breslow thickness or with MLBD were only associated with a worse disease-free survival rate in cases with positive (P < 0.01 and P = 0.047, respectively) and negative (P < 0.011 and P = 0.019, respectively) SLNB.


CONCLUSIONS
This study suggests that both Breslow thickness and the presence of MLBD are statistically significant independent prognostic factors of disease-free survival in patients with cutaneous melanoma.
Department of General Surgery, Hospital Universitario Virgen de la Arrixaca, El Palmar, 30120 Murcia, Spain. antonio.pinero@carm.es
Antonio
A
Piñero
Carlos
C
de Torre
Jorge
J
Martínez-Escribano
Juana
J
Campillo
Manuel
M
Canteras
Francisco
F
Nicolás
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000401:mortality / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology*; D055815:Young Adult