title: Sentinel lymph node status affects long-term survival in patients with intermediate-thickness melanoma.
abstract: OBJECTIVE
  The aim of this study was to examine the role of sentinel lymph node biopsy (SLNB) on long-term disease outcome in patients with intermediate-thickness primary cutaneous melanomas.
  
  
  METHODS
  Forty patients with intermediate-thickness melanomas, defined as 1.0-4.0 mm, underwent SLNB between 1998 and 2011. The disease-free survival (DFS), overall survival (OS) and prognostic factors were analyzed.
  
  
  RESULTS
  Median age was 53 years (range: 24-74 years). Median Breslow thickness was 2.8 mm (range: 1.0-4.0 mm) and 27.5% were ulcerated melanomas. Median follow-up time was 70 months (range: 23-168 months). The number of patients with sentinel lymph node (SLN)-positive was 9 (22.5%) and completion lymph node dissection was performed in all of these patients. Ten patients (25%) developed distant and locoregional recurrence; 4 in the SLN-positive group (4/9; 45%) and 6 in the SLN-negative group (6/31; 19%), P < 0.042. In the SLN-negative group, one patient developed regional node recurrence; false-negative rate was 10%. SLN positivity and ulceration were independent prognostic factors for DFS in multivariate analysis (hazard ratio [HR] of 4.6, and 10.5, respectively; P < 0.011). For OS SLN positivity, ulceration and Breslow thickness were found to be the significant prognostic factors (HR of 5.4, 8.5 and 5.0, respectively; P < 0.024). Ten-year DFS and OS for SLN-negative and SLN-positive patients were 71%, 47% (P < 0.003), and 80%, 55% (P < 0.005), respectively.
  
  
  CONCLUSIONS
  This study shows that survival rates are worse in the SLN-positive patients according to the long-term follow-up data. Ulceration and Breslow thickness also have significant effects on long-term survival in patients with intermediate-thickness primary cutaneous melanomas.
authors.affiliation: Department of Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Kaptan
authors.initials: K
authors.lastname: G Lben
authors.affiliation: Department of Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Berberoğlu
authors.affiliation: Department of Surgery, Bayındır Hospital Kavaklıdere, Ankara, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Altınyollar
authors.affiliation: Department of Surgery, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Kınaş
authors.affiliation: Department of Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Sevim
authors.initials: S
authors.lastname: Turanlı
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D000071036:Sentinel Lymph Node / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms; D016019:Survival Analysis; D055815:Young Adult; D000096142:Cutaneous Malignant Melanoma