title: Association of sentinel lymph node diameter with melanoma metastasis.
abstract: BACKGROUND
  Lymph nodes are an important part of the immune system and the size of the lymph node reflects local immunologic activity. The purpose of this study was to examine the association between sentinel lymph node (SLN) size and the presence of nodal metastasis in patients with melanoma.
  
  
  METHODS
  Retrospective review of a prospectively maintained database of patients undergoing SLN biopsy for cutaneous melanoma between February 1995 and January 2013. The maximum pathologic diameter and the volume of the largest node was used. A nodal diameter of 1.5 cm, included in 2 interquartile ranges of both positive and negative SLNs, was used as the cutoff for multivariate regression.
  
  
  RESULTS
  Of 1,017 SLN biopsies, 826 (81%) had complete size measurements and were included in the analysis. Patients with a positive SLN were younger (median 50 vs 53 years, P = .032), had deeper primary lesions (2 vs 1.4 mm, P < .001), and had larger SLN volume (.8 vs .6 cc, P = .009) or maximum diameter (1.9 vs. 1.6 cm, P = .03). Sex, pathologic ulceration, mitosis, and the type or location of the primary was not statistically different. On multivariate analysis; age, depth of primary, and both SLN volume and maximum diameter remained significant. An SLN greater than 1.5 cm in maximum diameter has a 60% increased odds ratio of being positive after adjusting for age, sex, and depth of primary lesion (P = .046).
  
  
  CONCLUSIONS
  Larger SLN maximum diameter is associated with nodal positivity independent of age, sex, depth of primary lesion, and location of SLN biopsy. The etiology and significance of larger SLNs warrant further analysis.
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Merkow
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Paniccia
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Jones
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Jones
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Maggie
authors.initials: M
authors.lastname: Hodges
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Stovall
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Kounalakis
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Csaba
authors.initials: C
authors.lastname: Gajdos
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Lewis
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: William
authors.initials: W
authors.lastname: Robinson
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Rene
authors.initials: R
authors.lastname: Gonzalez
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Pearlman
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado, Anschutz Medical Campus, Room 5401, 12631 E. 17th Ave., C302, Aurora, CO 80045, USA. Electronic address: martin.mccarter@ucdenver.edu.
authors.forename: Martin
authors.initials: M
authors.lastname: McCarter
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*; D000096142:Cutaneous Malignant Melanoma
keywords: Melanoma; Metastasis; Sentinel lymph node