43964
document
Influence of sentinel lymph node tumor burden on survival in melanoma . BACKGROUND Completion lymph node dissection ( CLND ) is the standard procedure for patients with positive sentinel lymph nodes ( SLN ) . With extensive pathological workup , increased numbers of small metastatic deposits are detected in SLN . This study evaluated the prognostic significance of SLN metastatic deposits < or = 0.2 mm in patients treated in a referral cancer center in Brazil . METHODS Patients with stage I/II melanoma , consecutively submitted to a SLN procedure by the same surgeon from 2000 to 2006 , were evaluated . All positive SLN and randomly selected negative cases were reviewed by two pathologists . Different prognostic factors and SLN tumor burden were recorded . Additional positive non-SLN after CLND , and disease outcome were evaluated . RESULTS Of 381 patients who underwent SLN biopsy , 103 ( 27 % ) were positive . The mean/median Breslow tumor thickness in the overall group was 3.4/2.0 mm and in the SLN positive patients was 5.72/4.0 mm . Among these patients , 48 ( 47 % ) had metastatic deposits > 2 mm ( macrometastasis ) , 49 ( 47 % ) had metastatic deposits < or =2 mm but > 0.2 mm ( micrometastasis ) , and 6 ( 6 % ) had metastatic deposits < or =0.2 mm ( submicrometastasis ) . Additional positive non-SLN were detected in 29 % of patients with macrometastasis , in 25 % of patients with micrometastasis , and in 0 % of patients with submicrometastases . At median follow-up of 35 months , the estimated 3-year overall survival was 92 % for negative SLN , 64 % for micrometastases , 53 % for macrometastases , and 100 % for submicrometastases ( P < 0.001 ) . CONCLUSION In the present study , patients with SLN metastatic deposits < or =0.2 mm had no additional positive non-SLNs , and no recurrences or deaths were recorded , suggesting that their prognosis is equivalent to that of patients with negative SLN .
43965
Intervention_Physical
Completion lymph node dissection ( CLND )
43966
Intervention_Surgical
SLN procedure
43967
Outcome_Physical
tumor thickness
43968
Participant_Condition
melanoma
43969
Participant_Condition
positive sentinel lymph nodes
43970
Participant_Condition
melanoma
43971
Participant_Sample-size
381
43972
Participant_Condition
SLN biopsy
43973
Participant_Sample-size
103