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J Surg Oncol. 2019 Jun;119(8):1060-1069. doi: 10.1002/jso.25445. Epub 2019 Mar 18.

Does sentinel lymph node status have prognostic significance in patients with acral lentiginous melanoma?

Author information

1
Aesthetic and Reconstructive Surgery Institute, UF Health Cancer Center-Orlando Health, Orlando, Florida.
2
Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas.
3
Section of Surgical Oncology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
4
Division of Surgical Oncology, Department of Surgery, Oregon Health and Science University, Portland, Oregon.

Abstract

BACKGROUND:

The prognostic benefit of sentinel lymph node biopsy (SLNB) and factors predictive of survival specifically in patients with acral lentiginous melanoma (ALM) are unknown.

METHODS:

The SEER database was queried for ALM cases that underwent SLNB from 1998 to 2013. Clinicopathological factors were correlated with SLN status, overall survival (OS), and melanoma-specific survival (MSS).

RESULTS:

Median age for the 753 ALM study patients was 65 years, and 48.2% were male. Median thickness was 2 mm with 38.1% of cases having ulceration. SLN metastases were detected in 194 of 753 cases (25.7%). Multivariable analysis showed that thickness, Clark level IV-V, and ulceration significantly predicted for SLN metastasis (P < 0.05). For patients with positive SLN, 5-year OS and MSS were significantly worse at 48.1% and 58.9%, respectively, compared with 78.7% and 88.5%, respectively, for patients with negative SLN (P < 0.0001). On multivariable analyses, older age, male gender, increasing thickness, ulceration, and a positive SLN significantly predicted for worse OS and MSS (all P < 0.05).

CONCLUSION:

This study confirms the important role of SLNB in ALM. SLN metastases are seen in 25.7% of ALM cases, providing significant prognostic information. In addition, thickness, ulceration status, and SLNB status significantly predict survival in patients with ALM.

KEYWORDS:

metastasis; nodal positivity; survival

PMID:
30883783
DOI:
10.1002/jso.25445
[Indexed for MEDLINE]

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