Transected thin melanoma: Implications for sentinel lymph node staging.
Journal Article (Journal Article)
BACKGROUND AND OBJECTIVES: Indications for sentinel lymph node (SLN) biopsy in patients with thin melanoma (≤1 mm thick) are controversial. We asked whether deep margin (DM) positivity at initial biopsy of thin melanoma is associated with SLN positivity. METHODS: Cases were identified using prospectively maintained databases at two melanoma centers. Patients who had undergone SLN biopsy for melanoma ≤1 mm were included. DM status was assessed for association with SLN metastasis in univariate and multivariate analyses. RESULTS: 1413 cases were identified, but only 1129 with known DM status were included. 39% of patients had a positive DM on original biopsy. DM-positive and DM-negative patients did not differ significantly in primary thickness, ulceration, or mitotic activity. DM-positive and DM-negative patients had similar incidence of SLN metastasis (5.7% vs 3.5%; P = 0.07). Positive DM was not associated with SLN metastasis on univariate analysis (OR 1.69, 95% CI: 0.95-3.00, P = 0.07) or on multivariate analysis adjusted for Breslow depth, Clark level, mitotic rate, and ulceration (OR = 1.59, 95% CI: 0.89-2.85; P = 0.12). CONCLUSIONS: For patients with thin melanoma, a positive DM on initial biopsy is not associated with risk of SLN metastasis, so DM positivity should not be considered an indication for SLN staging in an otherwise low-risk patient.
Full Text
Duke Authors
Cited Authors
- Herbert, G; Karakousis, GC; Bartlett, EK; Zaheer, S; Graham, D; Czerniecki, BJ; Fraker, DL; Ariyan, C; Coit, DG; Brady, MS
Published Date
- March 2018
Published In
Volume / Issue
- 117 / 4
Start / End Page
- 567 - 571
PubMed ID
- 29194673
Pubmed Central ID
- PMC5878707
Electronic International Standard Serial Number (EISSN)
- 1096-9098
Digital Object Identifier (DOI)
- 10.1002/jso.24930
Language
- eng
Conference Location
- United States