1. Is it Necessary to Perform Sentinel Lymph Node Biopsy in Thin Melanoma? A Retrospective Single Center Analysis
- Author
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Zs Kurgyis, Gábor Mohos, Judit Oláh, L Karsko, Balázs Bende, Albert Varga, Eszter Baltás, Lajos Kemény, Erika Varga, István Németh, Ádám Kocsis, József Varga, Henriette Ócsai, E Dosa-Racz, Erika Kis, László Pávics, Zs Besenyi, and Irma Korom
- Subjects
Adult ,Male ,Stage ,Cancer Research ,medicine.medical_specialty ,Skin Neoplasms ,Sentinel lymph node ,Single Center ,Pathology and Forensic Medicine ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Mitotic rate ,Biopsy ,Mitotic Index ,Medicine ,Humans ,Melanoma ,Aged ,Neoplasm Staging ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Sentinel Lymph Node Biopsy ,General Medicine ,Guideline ,Sentinel node ,Middle Aged ,medicine.disease ,Regression ,Oncology ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Mitotic Figure ,Female ,Original Article ,Radiology ,business - Abstract
Sentinel lymph node biopsy (SLNB) is a standard procedure for regional lymph node staging and still has the most important prognostic value for the outcome of patients with thin melanoma. In addition to ulceration, SLNB had to be considered even for a single mitotic figure in thin (2melanomas according to the AJCC7th staging system. SLNB was performed in 78 cases, of which nine (11.5%) showed SLN positivity. From them, interestingly, we found a relatively high positive sentinel rate (6/78–8%) in the case of thin primary melanomas ˂0.8 mm. Moreover, the presence of regression increased the probability of sentinel positivity by 5.796 fold. After reassessing pT stage based on the new AJCC8th, 37 pT1b cases were reordered into pT1a category. There was no significant relation between other characteristics examined (age, gender, Breslow, Clark level, and mitosis index) and sentinel node positivity. Based on our data, we suggest that mitotic rate alone is not a sufficiently powerful predictor of SLN status in thin melanomas. If strict histopathological definition criteria are applied, regression might be an additional adverse feature that aids in identifying T1 patients most likely to be SLN-positive. After reassessing of pT1b cases according to AJCC8thregression proved to be independent prognostic factor on sentinel lymph node positivity. Our results propose that sentinel lymph node biopsy might also be considered at patients with regressive thin (˂0.8 mm) melanomas.
- Published
- 2019