title: Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group.
abstract: OBJECTIVE
  The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis.
  
  
  METHODS
  This retrospective study included 633 patients with invasive melanoma who underwent sentinel lymph node biopsy in 7 referral centers certified by the Brazilian Melanoma Group. Independent risk factors of sentinel node metastasis (SNL) were identified by multiple logistic regression.
  
  
  RESULTS
  SLN metastasis was detected in 101 of 633 cases (16.1%) and in 93 of 428 patients (21.7%) when melanomas ≤ 1mm were excluded. By multiple logistic regression, the absence of TILs was as an independent risk factor of SLN metastasis (OR = 1.8; 95%CI: 1.1-3.0), in addition to Breslow index (greater than 2.00 mm), lymph vascular invasion, and presence of mitosis.
  
  
  CONCLUSIONS
  SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists.
authors: AC Camargo Cancer Center, São Paulo, Brazil.
authors: João Pedreira
authors: JP
authors: Duprat
authors: AC Camargo Cancer Center, São Paulo, Brazil.
authors: Eduard René
authors: ER
authors: Brechtbülh
authors: AC Camargo Cancer Center, São Paulo, Brazil.
authors: Bianca
authors: B
authors: Costa de Sá
authors: Medical School, São Paulo Federal University, São Paulo, Brazil.
authors: Mauro
authors: M
authors: Enokihara
authors: Barretos Cancer Hospital, Barretos, Brazil.
authors: Jose Humberto
authors: JH
authors: Fregnani
authors: Medical School, São Paulo Federal University, São Paulo, Brazil.
authors: Gilles
authors: G
authors: Landman
authors: Santa Casa de Misericórdia, São Paulo, Brazil.
authors: Marcus
authors: M
authors: Maia
authors: Santa Rita Hospital, Porto Alegre, Brazil.
authors: Felice
authors: F
authors: Riccardi
authors: Sirio Libanês Hospital, Oswaldo Cruz Hospital, São José Hospital, São Paulo, Brazil.
authors: Francisco Alberto
authors: FA
authors: Belfort
authors: Minas Gerais School of Medicine, Belo Horizonte, Brazil.
authors: Alberto
authors: A
authors: Wainstein
authors: AC Camargo Cancer Center, São Paulo, Brazil.
authors: Luciana F
authors: LF
authors: Moredo
authors: Mario Gatti Hospital, Campinas, Brazil.
authors: Higino
authors: H
authors: Steck
authors: AMO Clinic, Salvador, Brazil.
authors: Miguel
authors: M
authors: Brandão
authors: Medical School, Community University of Chapecó Region, Chapecó, Brazil.
authors: Marcelo
authors: M
authors: Moreno
authors: Oncology Department, Pernambuco University, Recife, Brazil.
authors: Eduardo
authors: E
authors: Miranda
authors: Medical School, São Paulo Federal University, São Paulo, Brazil.
authors: Ivan Dunshee de Oliveira
authors: ID
authors: Santos
mesh_terms: D001938:Brazil; D002452:Cell Count; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D016246:Lymphocytes, Tumor-Infiltrating / Q000166:cytology*; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies