TY  - JOUR
T1  - PRognostic information from sentinel lymph node biopsy in patients with thick melanoma
AU  - Scoggins CR, Bowen AL, Martin RC, II, et al
Y1  - 2010/07/01
N1  - 10.1001/archsurg.2010.115
JO  - Archives of Surgery
SP  - 622
EP  - 627
VL  - 145
IS  - 7
N2  - Hypothesis 
    Sentinel lymph node (SLN) biopsy provides valuable prognostic information for patients with thick (T4) melanoma.Design 
    Post hoc analysis of data from a prospective, randomized trial.Setting 
    Academic and private hospitals.Patients 
    Data of 240 patients with melanoma thicker than 4 mm were analyzed. Patients with tumor-positive SLNs underwent completion lymphadenectomy. Disease-free and overall survival were evaluated by Kaplan-Meier analysis. Univariate and multivariate analyses were performed to evaluate factors predictive of tumor-positive SLNs and disease-free and overall survival.Results 
    Median thickness of melanoma was 5.6 mm, and patients were followed up for a median of 50 months. The SLNs were tumor positive in 100 patients (41.7%); 18% of these had additional positive nodes on completion lymphadenectomy. Extremity tumor location (risk ratio, 1.66; 95% confidence interval, 1.24-2.24; P = .001), Clark level (1.95; 1.33-2.87; P = .02), and lymphovascular invasion (1.57; 1.13-2.17; P = .01) were associated with a greater risk of tumor-positive SLNs. The patients with tumor-negative SLNs had significantly better median disease-free survival (46.5 vs 31.0 months; P = .04) and overall survival (55.5 vs 43.0 months; P = .004) compared with patients with tumor-positive SLNs. On multivariate analysis, male sex (risk ratio, 1.59; 95% confidence interval, 1.05-2.50; P = .02), increasing Breslow thickness (1.58; 1.10- 2.30; P = .03), ulceration (1.73; 1.18-2.59; P = .02), and tumor-positive SLNs (1.68; 1.17-2.43; P = .009) were associated with worse overall survival.Conclusion 
    The SLN biopsy provides useful prognostic information for patients with T4 melanoma.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2010.115
UR  - http://dx.doi.org/10.1001/archsurg.2010.115
ER  -