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Sentinel Node Location in Trunk and Extremity Melanomas: Uncommon or Multiple Lymph Drainage Does Not Affect Survival

Gordon, Daniela; Smedby, Karin E.; Schultz, Inkeri; Olsson, Henrik; Ingvar, Christian LU ; Hansson, Johan and Gillgren, Peter (2014) In Annals of Surgical Oncology 21(11). p.3386-3394
Abstract
Patients with cutaneous melanoma (CM) on the trunk have a worse prognosis than those with extremity CM. One reason could be multiple or uncommon (outside axilla or groin) sentinel node locations (SNLs). We identified 859 patients who underwent sentinel node biopsy for trunk (n = 465) or extremity (n = 394) CM in three Swedish healthcare regions from 2000 to 2008. We collected patient, tumor, and sentinel node characteristics through clinical registers and medical records. We investigated the distribution of SNLs in a logistic regression model, and risk of overall and melanoma-specific death through 2011 in a multivariable Cox regression model. Trunk CM was associated with multiple SNLs (31 vs. 7 %; odds ratio [OR] 7.1; 95 % confidence... (More)
Patients with cutaneous melanoma (CM) on the trunk have a worse prognosis than those with extremity CM. One reason could be multiple or uncommon (outside axilla or groin) sentinel node locations (SNLs). We identified 859 patients who underwent sentinel node biopsy for trunk (n = 465) or extremity (n = 394) CM in three Swedish healthcare regions from 2000 to 2008. We collected patient, tumor, and sentinel node characteristics through clinical registers and medical records. We investigated the distribution of SNLs in a logistic regression model, and risk of overall and melanoma-specific death through 2011 in a multivariable Cox regression model. Trunk CM was associated with multiple SNLs (31 vs. 7 %; odds ratio [OR] 7.1; 95 % confidence interval [CI] 4.6-11.5; p < 0.001) but not uncommon SNLs (8 vs. 7 %; OR 1.1; 95 % CI 0.6-1.9; p = 0.75) compared with extremity CM. The increased risk of melanoma-specific death was confirmed for trunk CM (hazard ratio [HR] 1.9; 95 % CI 1.3-2.9; p = 0.003), especially on the upper back (HR 2.3; 95 % CI 1.4-3.6; p < 0.001) compared with extremity CM. Uncommon SNLs (HR 0.5; 95 % CI 0.2-1.4; p = 0.21) or multiple SNLs (HR 1.1; 95 % CI 0.4-2.9; p = 0.81) were not associated with melanoma-specific death compared with those with common/single SNL. Trunk melanomas were associated with multiple lymph drainage, but the worse prognosis of trunk melanomas could not be explained by the increased frequency of multiple or uncommon SNLs. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Surgical Oncology
volume
21
issue
11
pages
3386 - 3394
publisher
Springer
external identifiers
  • wos:000342144900009
  • scopus:84922547194
ISSN
1534-4681
DOI
10.1245/s10434-014-3744-0
language
English
LU publication?
yes
id
90f49793-f6ee-458c-ba33-a74cec7bb96e (old id 4699682)
date added to LUP
2014-11-03 07:20:39
date last changed
2017-09-03 04:06:10
@article{90f49793-f6ee-458c-ba33-a74cec7bb96e,
  abstract     = {Patients with cutaneous melanoma (CM) on the trunk have a worse prognosis than those with extremity CM. One reason could be multiple or uncommon (outside axilla or groin) sentinel node locations (SNLs). We identified 859 patients who underwent sentinel node biopsy for trunk (n = 465) or extremity (n = 394) CM in three Swedish healthcare regions from 2000 to 2008. We collected patient, tumor, and sentinel node characteristics through clinical registers and medical records. We investigated the distribution of SNLs in a logistic regression model, and risk of overall and melanoma-specific death through 2011 in a multivariable Cox regression model. Trunk CM was associated with multiple SNLs (31 vs. 7 %; odds ratio [OR] 7.1; 95 % confidence interval [CI] 4.6-11.5; p &lt; 0.001) but not uncommon SNLs (8 vs. 7 %; OR 1.1; 95 % CI 0.6-1.9; p = 0.75) compared with extremity CM. The increased risk of melanoma-specific death was confirmed for trunk CM (hazard ratio [HR] 1.9; 95 % CI 1.3-2.9; p = 0.003), especially on the upper back (HR 2.3; 95 % CI 1.4-3.6; p &lt; 0.001) compared with extremity CM. Uncommon SNLs (HR 0.5; 95 % CI 0.2-1.4; p = 0.21) or multiple SNLs (HR 1.1; 95 % CI 0.4-2.9; p = 0.81) were not associated with melanoma-specific death compared with those with common/single SNL. Trunk melanomas were associated with multiple lymph drainage, but the worse prognosis of trunk melanomas could not be explained by the increased frequency of multiple or uncommon SNLs.},
  author       = {Gordon, Daniela and Smedby, Karin E. and Schultz, Inkeri and Olsson, Henrik and Ingvar, Christian and Hansson, Johan and Gillgren, Peter},
  issn         = {1534-4681},
  language     = {eng},
  number       = {11},
  pages        = {3386--3394},
  publisher    = {Springer},
  series       = {Annals of Surgical Oncology},
  title        = {Sentinel Node Location in Trunk and Extremity Melanomas: Uncommon or Multiple Lymph Drainage Does Not Affect Survival},
  url          = {http://dx.doi.org/10.1245/s10434-014-3744-0},
  volume       = {21},
  year         = {2014},
}