Evaluation of Sentinel Lymph Node Status and its Association with Clinicopathological Factors in Patients with Cutaneous Melanoma: A Retrospective Study

2021 ◽  
Author(s):  
Arash Golpazir ◽  
Mehri Nazeri ◽  
Seyed mostafa meshkati yazd ◽  
Mohamadreza Karoobi ◽  
Houshang Nemati ◽  
...  
Keyword(s):  
Lymph Node ◽  
Retrospective Study ◽  
Sentinel Lymph Node ◽  
Cutaneous Melanoma ◽  
Regional Lymph Node ◽  
Mitotic Rate ◽  
Breslow Thickness ◽  
Lymph Node Status ◽  
Clinicopathological Factors ◽  
Angiolymphatic Invasion

Abstract Background: Cutaneous Melanoma (CM) is cancer with rising prevalence worldwide. The most significant predictor of CM is regional lymph node metastasis. Sentinel Lymph Node (SLN) biopsy has been used to stage CM and to identify lymphatic metastasis. This study aims to evaluate the SLN association with clinicopathological factors in the CM patients for a better surgical management. Methods: This retrospective study included 80 CM patients who had gone through lymphatic mapping and SLN biopsy at Imam Khomeini Hospital in Tehran from 2011 to 2018. The clinical and histologic factors, including sex, age, tumor location, Breslow thickness, ulceration, angiolymphatic invasion, tumor mitotic rate (TMR), and Clark level, were analyzed.Results: Fifty-six patients (70%) were found to have SLN, 19 patients (33.9%) were SLN-positive, and 37 patients (66.1%) were SLN-negative. Breslow thickness was the only variable that was significantly associated with the prediction of SLN. SLN was not correlated with other features such as ulceration, angiolymphatic invasion, and tumor mitotic rate. Complete Lymph Node Dissection (CLND) was carried out in 18 out of 19 SLN-positive patients. Moreover, 5 patients (27.8%) were found to be non-SLN-positive out of 18 SLN biopsy+CLND-positive patients. Furthermore, there was not any significant relationship between the clinicopathological features and the prediction of non-SLN. Conclusions: Breslow thickness was significantly correlated with positive SLN biopsy. Thus, it can be a strong predictor of positive SLN in CM patients.

Tumor-Infiltrating Lymphocyte Grade Is an Independent Predictor of Sentinel Lymph Node Status and Survival in Patients With Cutaneous Melanoma

2012 ◽  
Vol 30 (21) ◽  
pp. 2678-2683 ◽  
Author(s):  
Farhad Azimi ◽  
Richard A. Scolyer ◽  
Pavlina Rumcheva ◽  
Marc Moncrieff ◽  
Rajmohan Murali ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cutaneous Melanoma ◽  
Independent Predictor ◽  
Primary Melanoma ◽  
Mitotic Rate ◽  
Tumor Thickness ◽  
Lymph Node Status ◽  
Inverse Association ◽  
Grade 3

Purpose To determine whether density and distribution of tumor-infiltrating lymphocytes (TILs; TIL grade) is an independent predictor of sentinel lymph node (SLN) status and survival in patients with clinically localized primary cutaneous melanoma. Methods From the Melanoma Institute Australia database, 1,865 patients with a single primary melanoma ≥ 0.75 mm in thickness were identified. The associations of clinical and pathologic factors with SLN status, recurrence-free survival (RFS), and melanoma-specific survival (MSS) were analyzed. Results The majority of patients had either no (TIL grade 0; 35.4%) or few (TIL grade 1; 45.1%) TILs, with a minority showing moderate (TIL grade 2; 16.3%) or marked (TIL grade 3; 3.2%) TILs. Tumor thickness, mitotic rate, and Clark level were inversely correlated with TIL grade (each P < .001). SLN biopsy was performed in 1,138 patients (61.0%) and was positive in 252 (22.1%). There was a significant inverse association between SLN status and TIL grade (SLN positivity rates for each TIL grade: 0, 27.8%; 1, 20.1%; 2, 18.3%; 3, 5.6%; P < .001). Predictors of SLN positivity were decreasing age (P < .001), decreasing TIL grade (P < .001), ulceration (P = .003), increasing tumor thickness (P = .01), satellitosis (P = .03), and increasing mitoses (P = .03). The 5-year MSS and RFS rates were 83% and 76%, respectively (median follow-up, 43 months). Tumor thickness (P < .001), ulceration (P < .001), satellitosis (P < .001), mitotic rate (P = .003), TIL grade (P < .001), and sex (P = .01) were independent predictors of MSS. Patients with TIL grade 3 tumors had 100% survival. Conclusion TIL grade is an independent predictor of survival and SLN status in patients with melanoma. Patients with a pronounced TIL infiltrate have an excellent prognosis.

Tumor-Infiltrating Lymphocytes Predict Sentinel Lymph Node Positivity in Patients With Cutaneous Melanoma

2007 ◽  
Vol 25 (7) ◽  
pp. 869-875 ◽  
Author(s):  
Rebecca C. Taylor ◽  
Ami Patel ◽  
Katherine S. Panageas ◽  
Klaus J. Busam ◽  
Mary S. Brady
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cutaneous Melanoma ◽  
Prognostic Significance ◽  
Tumor Infiltrating Lymphocytes ◽  
Breslow Thickness ◽  
Anatomic Site ◽  
Primary Cutaneous Melanoma ◽  
Male Sex ◽  
Infiltrating Lymphocytes

Purpose Tumor-infiltrating lymphocytes (TILs) are considered a manifestation of the host immune response to tumor, but the influence of TILs on outcome remains controversial. Studies evaluating the prognostic significance of TILs were published before routine examination of draining lymph nodes by sentinel lymph node (SLN) biopsy, the most important predictor of survival in patients with melanoma. The prognostic implications of TILs were re-evaluated in a large group of patients undergoing SLN biopsy at our institution. Patients and Methods All patients who underwent SLN mapping for primary cutaneous melanoma between January 1996 and July 2005 were evaluated. Univariate and multivariate analyses were performed to assess factors that predict SLN positivity and survival. Factors analyzed included Breslow thickness, ulceration, anatomic site, sex, Clark level, age, mitotic rate, and the presence (brisk or nonbrisk) or absence of TIL. Results Eight hundred eighty-seven patients underwent SLN mapping, and a SLN was identified in 875 patients (98.8%). The SLN was positive for tumor in 156 patients (17.6%). Multivariate analysis revealed that only Breslow thickness (P < .0001), ulceration (P = .0004), male sex (P = .03), and absent TILs (P = .0003) were independently predictive of the presence of SLN metastases. In melanomas with a brisk TIL infiltrate, the probability of a positive SLN was 3.9% as compared with 26.2% for melanomas in which TILs were absent. TILs were not an independent predictive factor for survival. Conclusion The absence of TILs, together with increasing Breslow thickness, presence of ulceration and male sex, predicts SLN metastasis in patients undergoing SLN biopsy for primary cutaneous melanoma.

Sentinel Lymph Node Biopsy and Management of Regional Lymph Nodes in Melanoma: American Society of Clinical Oncology and Society of Surgical Oncology Clinical Practice Guideline Update

2018 ◽  
Vol 36 (4) ◽  
pp. 399-413 ◽  
Author(s):  
Sandra L. Wong ◽  
Mark B. Faries ◽  
Erin B. Kennedy ◽  
Sanjiv S. Agarwala ◽  
Timothy J. Akhurst ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Clinical Oncology ◽  
Surgical Oncology ◽  
Breslow Thickness ◽  
Clinicopathological Factors ◽  
Careful Observation ◽  
Randomized Controlled ◽  
Potential Benefits ◽  
American Society

Purpose To update the American Society of Clinical Oncology (ASCO)-Society of Surgical Oncology (SSO) guideline for sentinel lymph node (SLN) biopsy in melanoma. Methods An ASCO-SSO panel was formed, and a systematic review of the literature was conducted regarding SLN biopsy and completion lymph node dissection (CLND) after a positive sentinel node in patients with melanoma. Results Nine new observational studies, two systematic reviews, and an updated randomized controlled trial of SLN biopsy, as well as two randomized controlled trials of CLND after positive SLN biopsy, were included. Recommendations Routine SLN biopsy is not recommended for patients with thin melanomas that are T1a (nonulcerated lesions < 0.8 mm in Breslow thickness). SLN biopsy may be considered for thin melanomas that are T1b (0.8 to 1.0 mm Breslow thickness or < 0.8 mm Breslow thickness with ulceration) after a thorough discussion with the patient of the potential benefits and risk of harms associated with the procedure. SLN biopsy is recommended for patients with intermediate-thickness melanomas (T2 or T3; Breslow thickness of > 1.0 to 4.0 mm). SLN biopsy may be recommended for patients with thick melanomas (T4; > 4.0 mm in Breslow thickness), after a discussion of the potential benefits and risks of harm. In the case of a positive SLN biopsy, CLND or careful observation are options for patients with low-risk micrometastatic disease, with due consideration of clinicopathological factors. For higher-risk patients, careful observation may be considered only after a thorough discussion with patients about the potential risks and benefits of foregoing CLND. Important qualifying statements outlining relevant clinicopathological factors and details of the reference patient populations are included within the guideline. Additional information is available at www.asco.org/melanoma-guidelines and www.asco.org/guidelineswiki .

scholarly journals The sentinel lymph node status is an important factor for predicting clinical outcome in patients with Stage I or II cutaneous melanoma

Cancer ◽  
2001 ◽  
Vol 91 (12) ◽  
pp. 2401-2408 ◽  
Author(s):  
Markwin G. Statius Muller ◽  
Paul A. M. van Leeuwen ◽  
Elly S. M de Lange-de Klerk ◽  
Paul J. van Diest ◽  
Rik Pijpers ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Clinical Outcome ◽  
Cutaneous Melanoma ◽  
Stage I ◽  
Lymph Node Status ◽  
Node Status ◽  
Sentinel Lymph Node Status

Primary Cutaneous Melanoma

2018 ◽  
Author(s):  
Clara R Farley ◽  
Keith A Delman ◽  
Michael C Lowe
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Local Excision ◽  
Cutaneous Melanoma ◽  
Wide Local Excision ◽  
Lymph Node Biopsy ◽  
Lymph Node Status ◽  
Primary Cutaneous Melanoma ◽  
Node Biopsy

Melanoma presents a significant health burden as its incidence continues to rise in both sexes and remains the most common cause of skin cancer–related death. Risk factors for the development of melanoma include sun exposure, fair complexion, increasing age, previous melanoma, multiple dysplastic nevi, and familial syndromes. Wide local excision is the standard of care for those with early forms of melanoma, with sentinel lymph node biopsy in appropriate populations. Sentinel lymph node status contributes to the discussion as to whether to pursue completion lymphadenectomy. This review outlines surgical treatment of primary cutaneous melanoma, including wide local excision, sentinel lymph node biopsy, and completion lymphadenectomy.   This review contains 10 figures, 4 tables and 33 references Key words: biopsy, cutaneous, lymphadenectomy, margin, melanoma, pathology, primary, sentinel node, surgery, treatment  

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