Predictive factors for sentinel lymph nodes and non-sentinel lymph nodes metastatic involvement: a database study of 1,041 melanoma patients.
BACKGROUND
Sentinel lymph node (SLN) biopsy may identify patients who may need completion lymphadenectomy and adjuvant therapy.


METHODS
Univariate and multivariate analysis were conducted for SLN status in a prospective cohort of 1,041 patients. A biopsy was recommended for melanoma greater than or equal to 1 mm thick or greater than or equal to .75 mm with poor prognostic features.


RESULTS
For sentinel node status, mitotic rate is very significant in univariate analysis. In multivariate analysis, Breslow, lymphovascular invasion, and primary site were significant. Breslow thickness greater than or equal to 2 mm and SLN with macroscopic burden greater than or equal to 2 mm are the only statistically significant variables predicting the non-SLN status in multivariate analysis.


CONCLUSIONS
The data confirm the importance of Breslow, lymphovascular invasion, and body site for SLN status. The cutoff of 2 mm for tumor load in SLN appears to be a simple technique to find the high-risk patients with further lymph node disease.
Department of Surgery, CHU de Québec, Hôtel-Dieu de Québec, 11 Côte du Palais, Québec, QC G1R 2J6, Canada. Electronic address: drantoine.kibrite@sympatico.ca.
Antoine
A
Kibrité
Department of General Surgery, Hôpital Le Royer, Baie-Comeau, QC, Canada.
Héléne
H
Milot
Department of Medical Biology, CHU de Québec, Hôtel-Dieu de Québec, Québec, QC, Canada.
Pierre
P
Douville
Department of Medical Biology, CHU de Québec, Hôtel-Dieu de Québec, Québec, QC, Canada.
Éric J
ÉJ
Gagné
Department of Medical Biology, CHU de Québec, Hôtel-Dieu de Québec, Québec, QC, Canada.
Sébastien
S
Labonté
Medical Imaging Department, CHU de Québec, Hôtel-Dieu de Québec, Québec, QC, Canada.
Juan
J
Friede
Medical Imaging Department, CHU de Québec, Hôtel-Dieu de Québec, Québec, QC, Canada.
Francis
F
Morin
Department of Surgery, CHU de Québec, Hôtel-Dieu de Québec, 11 Côte du Palais, Québec, QC G1R 2J6, Canada.
Jean-François
JF
Ouellet
Department of Dermatology, CHU de Québec, Hôtel-Dieu de Québec, Québec, QC, Canada.
Joël
J
Claveau
D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011446:Prospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*
Breslow thickness; Lymphadenectomy; Lymphovascular invasion; Melanoma; Mitotic rate; Sentinel lymph node