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


  • eng

Conference Location

  • United States