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The natural history of thin melanoma and the utility of sentinel lymph node biopsy.

Abstract：

BACKGROUND AND OBJECTIVES:Current literature may overestimate the risk of nodal metastasis from thin melanoma due to reporting of data only from lesions treated with SLNB. Our objective was to define the natural history of thin melanoma, assessing the likelihood of nodal disease, in order to guide selection for SLNB. METHODS:Retrospective review. The primary outcome was the rate of nodal disease. Clinicopathologic factors were evaluated to find associations with nodal disease. RESULTS:Five hundred and twelve lesions, follow up available for 488 (median: 48 months). Lesions treated with WLE/SLNB compared to WLE alone were more likely to have high-risk features. The rate of nodal disease was higher in the WLE/SLNB group (24 positive SLNB, five false-negative SLNB with nodal recurrence: 10.2%) compared to WLE alone (four nodal recurrences: 2.0%). Univariate analysis showed age ≤45, Breslow depth ≥0.85 mm, mitotic rate >1 mm2 , and ulceration were associated with nodal disease. Multivariate analysis confirmed the association of age ≤45 and ulceration. CONCLUSIONS:SLNB for melanoma 0.75-0.99 mm should be considered in patients age ≤45, Breslow depth ≥0.85 mm, mitotic rate >1 mm2 , and/or with ulceration. Thin melanoma <0.85 mm without high-risk features may be treated with WLE alone.

journal_name

J Surg Oncol

journal_title

Journal of surgical oncology

authors

Durham AB,Schwartz JL,Lowe L,Zhao L,Johnson AG,Harms KL,Bichakjian CK,Orsini AP,McLean SA,Bradford CR,Cohen MS,Johnson TM,Sabel MS,Wong SL

doi

10.1002/jso.24765

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1185-1192

issue

8

eissn

0022-4790

issn

1096-9098

journal_volume

116

pub_type

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