title: Sentinel node studies in truncal melanoma: does an increased number of draining basins correlate with an increased risk of lymph metastasis?
abstract: OBJECTIVE
  To assess whether an association exists between drainage to multiple basins and lymphatic metastasis in patients with truncal melanoma.
  
  
  METHODS
  We retrospectively reviewed 227 patients with primary malignant melanoma between January 2006 and December 2009. All patients received an intradermal injection of (99m)Tc-nanocolloid and lymphoscintigraphy followed by sentinel node biopsy. Pre-staging histology with Breslow thickness from excision biopsy was also obtained.
  
  
  RESULTS
  82/227 (36%) patients with primary truncal melanoma were identified. Nodal histology was positive for metastatic disease in 27/82 (32.9%) patients. Of these 27, 15 had 1 basin of drainage, 7 had 2 basins of drainage and 5 had 3 basins of drainage. Of the 55 node-negative patients, 35 had 1 basin, 18 had 2 basins and 2 had 3 basins of drainage. We found no significant correlation with sentinel node positivity and those that had ≥2 drainage basins. Breslow thickness was available in 65/82(79.2%) patients. Sentinel node biopsy was positive in 6/28 patients who had <1.5 mm thickness, 8/14 who had a 1.5-3.9 mm thickness and 9/23 who had ≥4 mm thickness. There was a significant correlation between Breslow thickness of ≥4 mm and nodal positivity (P = 0.03).
  
  
  CONCLUSIONS
  This study demonstrates no association between multiple drainage basins and sentinel node histology. Sentinel lymph node status did correlate with Breslow thickness.
authors.affiliation: Department of Nuclear Medicine, Royal Free Hospital, London, UK. shaunakn@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Navalkissoor
authors.forename: P S J
authors.initials: PS
authors.lastname: Bailey
authors.forename: A M
authors.initials: AM
authors.lastname: Quigley
authors.forename: M
authors.initials: M
authors.lastname: Hall
authors.forename: J R
authors.initials: JR
authors.lastname: Buscombe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy