Format

Send to

Choose Destination
See comment in PubMed Commons below
J Dtsch Dermatol Ges. 2008 Mar;6(3):198-203. Epub 2007 Dec 17.

Sentinel lymph node status is the most important prognostic factor for thick (> or = 4 mm) melanomas.

[Article in English, German]

Author information

1
Department of Dermatology and Venereology, Skin Tumor Center Hannover (HTZH), Hannover Medical School, Hannover, Germany. gutzmer.ralf@mh-hannover.de

Abstract

BACKGROUND:

The value of the status of the sentinel lymph node (SLN) in patients with thick melanomas (Breslow thickness > or = 4 mm) is controversial.

PATIENTS AND METHODS:

Using Kaplan-Meier estimates and Cox regression models, we studied 152 patients with primary melanomas > or = 4 mm thickness who underwent sentinel lymph node excision (SLNE) at the university hospitals of Hannover and Göttingen, Germany, between 1998 and 2006.

RESULTS:

The median tumor thickness was 5.2 (4-18) mm; 58.5% of primary melanomas were ulcerated. Micrometastasis to a SLN was found in 48.7%. The patients with positive SLNs were significantly younger than those with negative SLN (p = 0.01). Of the complete lymph node dissections, 32% contained positive non-SLN. The estimated 5 year recurrence-free survival was 42.5 +/- 5% (+/- standard error) (26.3 +/- 6.6% after positive SLNE, 58.7 +/- 7.1% after negative SLNE). The 5 year overall survival rate was 53.2 +/- 5.4% (37.5 +/- 8.1% after positive SLNE, 67.6 +/- 6.7% after negative SLNE). By multivariate analysis, the SLN was a highly significant predictor for overall survival (p = 0.007, relative risk 2.3, 95%, confidence interval 1.2-4.2). The overall survival was significantly associated with penetration of nodal metastases into the SLN > 0.3 mm (p = 0.001). Other parameters such as tumor thickness, ulceration, age and sex were not significant. In the subgroup of patients with negative SLN, neither tumor thickness nor ulceration was significant.

CONCLUSIONS:

The status of the SLN represents the most important prognostic parameter in patients with thick melanomas, whereas other parameters such as tumor thickness and ulceration loose their prognostic value.

[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center