Is it Necessary to Perform Sentinel Lymph Node Biopsy in Thin Melanoma? A Retrospective Single Center Analysis
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 (
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| Veröffentlicht in: | Pathology oncology research 2020-07, Vol.26 (3), p.1861-1868 |
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| creator | Kocsis, A. Karsko, L. Kurgyis, Zs Besenyi, Zs Pavics, L. Dosa-Racz, E. Kis, E. Baltas, E. Ocsai, H. Varga, E. Bende, B. Varga, A. Mohos, G. Korom, I. Varga, J. Kemeny, L. Nemeth, I. B. Olah, J. |
| description | 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 ( |
| doi_str_mv | 10.1007/s12253-019-00769-z |
| format | Article |
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2
melanomas 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 AJCC8
th
, 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 AJCC8
th
regression 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.</description><identifier>ISSN: 1219-4956</identifier><identifier>EISSN: 1532-2807</identifier><identifier>DOI: 10.1007/s12253-019-00769-z</identifier><identifier>PMID: 31792874</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adult ; Aged ; Biomedical and Life Sciences ; Biomedicine ; Biopsy ; Cancer Research ; Female ; Humans ; Immunology ; Lymph nodes ; Lymphatic Metastasis - diagnosis ; Lymphatic Metastasis - pathology ; Lymphatic system ; Male ; Melanoma ; Melanoma - diagnosis ; Melanoma - pathology ; Melanoma, Cutaneous Malignant ; Middle Aged ; Mitosis ; Mitotic Index ; Neoplasm Staging - methods ; Oncology ; Original ; Original Article ; Pathology ; Retrospective Studies ; Sentinel Lymph Node Biopsy - methods ; Skin Neoplasms - diagnosis ; Skin Neoplasms - pathology ; Young Adult</subject><ispartof>Pathology oncology research, 2020-07, Vol.26 (3), p.1861-1868</ispartof><rights>The Author(s) 2019</rights><rights>The Author(s) 2019. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-e3408b5adc60a4052034f5124c8f48c507a45c3eef51de0cd975c74cd51c4a633</citedby><cites>FETCH-LOGICAL-c441t-e3408b5adc60a4052034f5124c8f48c507a45c3eef51de0cd975c74cd51c4a633</cites><orcidid>0000-0003-0161-4277</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12253-019-00769-z$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12253-019-00769-z$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31792874$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kocsis, A.</creatorcontrib><creatorcontrib>Karsko, L.</creatorcontrib><creatorcontrib>Kurgyis, Zs</creatorcontrib><creatorcontrib>Besenyi, Zs</creatorcontrib><creatorcontrib>Pavics, L.</creatorcontrib><creatorcontrib>Dosa-Racz, E.</creatorcontrib><creatorcontrib>Kis, E.</creatorcontrib><creatorcontrib>Baltas, E.</creatorcontrib><creatorcontrib>Ocsai, H.</creatorcontrib><creatorcontrib>Varga, E.</creatorcontrib><creatorcontrib>Bende, B.</creatorcontrib><creatorcontrib>Varga, A.</creatorcontrib><creatorcontrib>Mohos, G.</creatorcontrib><creatorcontrib>Korom, I.</creatorcontrib><creatorcontrib>Varga, J.</creatorcontrib><creatorcontrib>Kemeny, L.</creatorcontrib><creatorcontrib>Nemeth, I. B.</creatorcontrib><creatorcontrib>Olah, J.</creatorcontrib><title>Is it Necessary to Perform Sentinel Lymph Node Biopsy in Thin Melanoma? A Retrospective Single Center Analysis</title><title>Pathology oncology research</title><addtitle>Pathol. Oncol. Res</addtitle><addtitle>Pathol Oncol Res</addtitle><description>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 (<1 mm) melanoma according to AJCC7th guideline, therefore, a retrospective review was conducted involving 403 pT1 melanoma patients. Among them, 152 patients suffered from pT1b ulcerated or mitotic rate ≥ 1/ mm
2
melanomas 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 AJCC8
th
, 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 AJCC8
th
regression 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Biopsy</subject><subject>Cancer Research</subject><subject>Female</subject><subject>Humans</subject><subject>Immunology</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis - diagnosis</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Melanoma</subject><subject>Melanoma - diagnosis</subject><subject>Melanoma - pathology</subject><subject>Melanoma, Cutaneous Malignant</subject><subject>Middle Aged</subject><subject>Mitosis</subject><subject>Mitotic Index</subject><subject>Neoplasm Staging - methods</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Pathology</subject><subject>Retrospective Studies</subject><subject>Sentinel Lymph Node Biopsy - methods</subject><subject>Skin Neoplasms - diagnosis</subject><subject>Skin Neoplasms - pathology</subject><subject>Young Adult</subject><issn>1219-4956</issn><issn>1532-2807</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9UctO3DAUtRAVj2l_gEVliXXAzzjZtBpGbUGa0qrQtWWcmxmjxA52Bmn4-hpmgLJh49c599x7fBA6ouSEEqJOE2VM8oLQusjXsi4edtABlZwVrCJqN59ZhkQty310mNIteWKVe2ifU1WzSokD5C8SdiO-BAspmbjGY8C_IbYh9vgK_Og8dHi-7oclvgwN4DMXhrTGzuPrZV5-Qmd86M1XPMV_YIwhDWBHdw_4yvlFB3iWNSDiqTfdOrn0EX1oTZfg03afoL_fv13Pzov5rx8Xs-m8sELQsQAuSHUjTWNLYgSRjHDRSsqErVpRWUmUEdJygPzYALFNraRVwjaSWmFKzifoy0Z3WN300Ng8RTSdHqLrs0kdjNNvEe-WehHutWK1qpjKAsdbgRjuVpBGfRtWMbtImgkqCCMlZ5nFNiybnacI7UsHSvRjRnqTkc4Z6aff1w-56PP_s72UPIeSCXxDSBnyC4ivvd-R_QdLU56Q</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Kocsis, A.</creator><creator>Karsko, L.</creator><creator>Kurgyis, Zs</creator><creator>Besenyi, Zs</creator><creator>Pavics, L.</creator><creator>Dosa-Racz, E.</creator><creator>Kis, E.</creator><creator>Baltas, E.</creator><creator>Ocsai, H.</creator><creator>Varga, E.</creator><creator>Bende, B.</creator><creator>Varga, A.</creator><creator>Mohos, G.</creator><creator>Korom, I.</creator><creator>Varga, J.</creator><creator>Kemeny, L.</creator><creator>Nemeth, I. 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B.</au><au>Olah, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is it Necessary to Perform Sentinel Lymph Node Biopsy in Thin Melanoma? A Retrospective Single Center Analysis</atitle><jtitle>Pathology oncology research</jtitle><stitle>Pathol. Oncol. Res</stitle><addtitle>Pathol Oncol Res</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>26</volume><issue>3</issue><spage>1861</spage><epage>1868</epage><pages>1861-1868</pages><issn>1219-4956</issn><eissn>1532-2807</eissn><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 (<1 mm) melanoma according to AJCC7th guideline, therefore, a retrospective review was conducted involving 403 pT1 melanoma patients. Among them, 152 patients suffered from pT1b ulcerated or mitotic rate ≥ 1/ mm
2
melanomas 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 AJCC8
th
, 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 AJCC8
th
regression 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.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>31792874</pmid><doi>10.1007/s12253-019-00769-z</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0161-4277</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Biomedical and Life Sciences Biomedicine Biopsy Cancer Research Female Humans Immunology Lymph nodes Lymphatic Metastasis - diagnosis Lymphatic Metastasis - pathology Lymphatic system Male Melanoma Melanoma - diagnosis Melanoma - pathology Melanoma, Cutaneous Malignant Middle Aged Mitosis Mitotic Index Neoplasm Staging - methods Oncology Original Original Article Pathology Retrospective Studies Sentinel Lymph Node Biopsy - methods Skin Neoplasms - diagnosis Skin Neoplasms - pathology Young Adult |
| title | Is it Necessary to Perform Sentinel Lymph Node Biopsy in Thin Melanoma? A Retrospective Single Center Analysis |
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