No non-sentinel node involvement in melanoma patients with limited Breslow thickness and low sentinel node tumour load

Thomas Bogenrieder, Marijke R. van Dijk, Willeke A.M. Blokx, Katrin Ramrath, Kees Seldenrijk, Wilhelm Stolz, Paulus Joannes van Diest

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Aims: Most melanoma patients with a positive sentinel node (SN) undergo completion lymph node dissection and frequently experience associated morbidity. However, only 10-30% of SN-positive patients have further lymph node metastases. The aim of the present study was to predict the absence of non-SN metastases in a multicentre study of patients with a positive SN based on primary melanoma features and SN tumour load. Methods and results: Of 70 SN positive patients, 18 had non-SN metastases. Penetrative depth of metastatic cells into the SN and SN tumour load was assessed by morphometry. None of the 14 patients (20%) with a Breslow thickness <2.0mm and an SN tumour load <0.2mm 2 had non-SN metastases. Similarly, none of the 15 patients (21%) with a Breslow thickness <2.0mm and SN penetrative depth <600μm had non-SN metastases. Lastly, none of the 14 patients (20%) with a Breslow thickness <2.0mm and a diameter of the largest SN deposit <500μm had non-SN metastases. Conclusions: A combination of limited Breslow thickness and low SN tumour load predicts absence of non-SN metastases in melanoma patients with a positive SN with high accuracy. We propose that this subgroup may be spared completion lymph node dissection.

Original languageEnglish (US)
Pages (from-to)318-326
Number of pages9
JournalHistopathology
Volume59
Issue number2
DOIs
StatePublished - Aug 2011
Externally publishedYes

Keywords

  • Lymph node metastases
  • Lymph node staging
  • Melanoma
  • S-classification
  • Sentinel lymph node

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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