title: Popliteal sentinel lymph node involvement in melanoma patients.
abstract: BACKGROUND
  Sentinel lymph nodes (SLN) in popliteal basins are rare, and there is controversy in literature regarding their origin, management, and outcomes.
  
  
  OBJECTIVE
  To correlate clinical and pathological features of popliteal basin drainage and analyze the impact of popliteal lymph node drainage on survival.
  
  
  METHODS
  Retrospective analysis of SLN biopsies performed at a single institution between 2000 and 2010.
  
  
  RESULTS
  SLN biopsies were performed in 254 patients with melanoma in lower limbs, 247 of which were evaluated. In this group, there were 59 patients (24%) with a positive SLN. Twenty-seven cases (11%) presented with popliteal drainage, one of which lacked concurrent groin drainage. Among these 27 patients, three (11%) had popliteal metastasis, one of which had exclusive involvement of this basin. Popliteal drainage was associated with worse 5-year disease-free survival (DFS) (P = 0.028) but not 5-year overall survival (OS) (P = 0.219) in univariate analysis. In multivariate analysis, Breslow thickness, mitotic index, and positive SLN were prognostic factors for DFS. Only mitotic index correlated significantly with OS (P = 0.044).
  
  
  CONCLUSIONS
  Popliteal drainage seems to be associated with worse prognostic features of the primary tumor.
authors.affiliation: Skin Cancer Department, AC Camargo Cancer Center, São Paulo/SP, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bertolli
authors.affiliation: Breast Cancer Department, AC Camargo Cancer Center, São Paulo, Brazil.
authors.forename: José Luiz Barbosa
authors.initials: JL
authors.lastname: Bevilacqua
authors.affiliation: Skin Cancer Department, AC Camargo Cancer Center, São Paulo/SP, Brazil.
authors.forename: André Sapata
authors.initials: AS
authors.lastname: Molina
authors.affiliation: Pathology Department, AC Camargo Cancer Center, São Paulo, Brazil.
authors.forename: Mariana Petaccia
authors.initials: MP
authors.lastname: de Macedo
authors.affiliation: Pathology Department, AC Camargo Cancer Center, São Paulo, Brazil.
authors.forename: Clovis Antonio Lopes
authors.initials: CA
authors.lastname: Pinto
authors.affiliation: Skin Cancer Department, AC Camargo Cancer Center, São Paulo/SP, Brazil.
authors.forename: João Pedreira
authors.initials: JP
authors.lastname: Duprat Neto
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D035002:Lower Extremity; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D011152:Popliteal Vein; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: lymphatic metastasis; melanoma; sentinel lymph node biopsy