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Sentinel lymph node biopsy in patients with thin melanomas : Frequency and predictors of metastasis based on analysis of two large international cohorts

Isaksson, Karolin LU ; Nielsen, Kari LU ; Mikiver, Rasmus; Nieweg, Omgo E.; Scolyer, Richard A.; Thompson, John F. and Ingvar, Christian LU (2018) In Journal of Surgical Oncology 118(4). p.599-605
Abstract

Background: Sentinel lymph node (SLN) metastasis in patients with thin melanomas (≤1 mm) is uncommon but adverse prognostic factors may indicate an increased risk. We sought to determine how often SLN biopsy (SLNB) was performed in patients with thin melanomas, establish the frequency of SLN metastasis and evaluate the predictive value of ulceration, tumor mitotic rate, and thickness for SLN involvement. Methods: Melanoma patients with a Breslow thickness greater than or equal to 0.5 to less than or equal to 1 mm, diagnosed 2009-2016, were identified in the Swedish Melanoma Register (SMR) and the Melanoma Institute Australia (MIA) Database. Results: In total 8165 patients were included from the SMR and 1603 from MIA. SLNB was performed... (More)

Background: Sentinel lymph node (SLN) metastasis in patients with thin melanomas (≤1 mm) is uncommon but adverse prognostic factors may indicate an increased risk. We sought to determine how often SLN biopsy (SLNB) was performed in patients with thin melanomas, establish the frequency of SLN metastasis and evaluate the predictive value of ulceration, tumor mitotic rate, and thickness for SLN involvement. Methods: Melanoma patients with a Breslow thickness greater than or equal to 0.5 to less than or equal to 1 mm, diagnosed 2009-2016, were identified in the Swedish Melanoma Register (SMR) and the Melanoma Institute Australia (MIA) Database. Results: In total 8165 patients were included from the SMR and 1603 from MIA. SLNB was performed in 9.5% and 16.2% of patients, respectively. Corresponding figures for T1b (American Joint Committee on Cancer [AJCC] 7th Edition) were 19.5% and 24.6%. The SLN positivity rate were 4.4% (Sweden) and 5.8% (MIA). SLN metastasis was more frequent in tumors with ulceration, mitoses, and Breslow thickness greater than or equal to 0.9 mm but none were statistically significant. Younger age was identified as a significant risk factor for SLN positivity at MIA. Conclusions: A minority of patients with thin melanomas had SLNB performed and the SLN positivity rate was low. This study did not confirm tumor ulceration, mitoses, or thickness as statistically significant predictors for SLN metastasis.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
mitoses, sentinel lymph node biopsy, thickness, thin melanoma, ulceration
in
Journal of Surgical Oncology
volume
118
issue
4
pages
599 - 605
publisher
Wiley-Blackwell
external identifiers
  • scopus:85053473834
ISSN
0022-4790
DOI
10.1002/jso.25208
language
English
LU publication?
yes
id
25d58cb3-32b2-4047-990d-a3b44a5a7eda
date added to LUP
2018-10-26 08:15:13
date last changed
2019-02-20 11:33:27
@article{25d58cb3-32b2-4047-990d-a3b44a5a7eda,
  abstract     = {<p>Background: Sentinel lymph node (SLN) metastasis in patients with thin melanomas (≤1 mm) is uncommon but adverse prognostic factors may indicate an increased risk. We sought to determine how often SLN biopsy (SLNB) was performed in patients with thin melanomas, establish the frequency of SLN metastasis and evaluate the predictive value of ulceration, tumor mitotic rate, and thickness for SLN involvement. Methods: Melanoma patients with a Breslow thickness greater than or equal to 0.5 to less than or equal to 1 mm, diagnosed 2009-2016, were identified in the Swedish Melanoma Register (SMR) and the Melanoma Institute Australia (MIA) Database. Results: In total 8165 patients were included from the SMR and 1603 from MIA. SLNB was performed in 9.5% and 16.2% of patients, respectively. Corresponding figures for T1b (American Joint Committee on Cancer [AJCC] 7th Edition) were 19.5% and 24.6%. The SLN positivity rate were 4.4% (Sweden) and 5.8% (MIA). SLN metastasis was more frequent in tumors with ulceration, mitoses, and Breslow thickness greater than or equal to 0.9 mm but none were statistically significant. Younger age was identified as a significant risk factor for SLN positivity at MIA. Conclusions: A minority of patients with thin melanomas had SLNB performed and the SLN positivity rate was low. This study did not confirm tumor ulceration, mitoses, or thickness as statistically significant predictors for SLN metastasis.</p>},
  author       = {Isaksson, Karolin and Nielsen, Kari and Mikiver, Rasmus and Nieweg, Omgo E. and Scolyer, Richard A. and Thompson, John F. and Ingvar, Christian},
  issn         = {0022-4790},
  keyword      = {mitoses,sentinel lymph node biopsy,thickness,thin melanoma,ulceration},
  language     = {eng},
  month        = {09},
  number       = {4},
  pages        = {599--605},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Surgical Oncology},
  title        = {Sentinel lymph node biopsy in patients with thin melanomas : Frequency and predictors of metastasis based on analysis of two large international cohorts},
  url          = {http://dx.doi.org/10.1002/jso.25208},
  volume       = {118},
  year         = {2018},
}