Pattern and incidence of first site recurrences following sentinel node procedure in melanoma patients.

Abstract:

:Studies of large series of melanoma patients indicated that the average incidence of developing a recurrence during follow-up was 40%. The most frequent first sites of these recurrences were the regional lymph nodes. We hypothesized that the sentinel node (SN) procedure may change the pattern of recurrence by reducing the number of first recurrences in the regional lymph node basin during follow-up to a negligible number, and that locoregional cutaneous and distance metastases are the major future sites of recurrence. We further studied the influence of SN status together with different influential factors on prognosis. An SN procedure with a triple technique was performed in 250 consecutive patients with proven AJCC stages I and II cutaneous melanoma. The median follow-up was 38 months. So far, 44 patients (18%) have developed a recurrence of the disease. The distribution of localization of the first metastases was as follows: 23 patients (52%) with a locoregional cutaneous recurrence; 4 (9%) with recurrence in the regional lymph node basin; 2 (5%) with recurrence in an interval node; and 15 (34%) with distant recurrence. The relative risk of developing recurrence for SN-positive patients is 4.2; for Breslow thickness of 1.51 to 4.00 mm it is 5.5, and thicker than 4.0 mm it is 6.2; for lymphatic invasion 7.6; and for ulceration 3.8. We conclude that the SN procedure changes the pattern of recurrences during follow-up by reducing the number of first recurrences within the regional lymph node basin to a negligible number. High Breslow thickness, lymphatic invasion, and ulceration of the primary melanoma are strong risk factors for recurrence.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Statius Muller MG,van Leeuwen PA,van Diest PJ,Pijpers R,Nijveldt RJ,Vuylsteke RJ,Meijer S

doi

10.1007/s00268-002-6197-8

keywords:

subject

Has Abstract

pub_date

2002-12-01 00:00:00

pages

1405-11

issue

12

eissn

0364-2313

issn

1432-2323

journal_volume

26

pub_type

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