The S-100B level measured preoperatively is, in contrast to LDH, one of the most important independent predictors of melanoma prognosis in patients undergoing TLND for nodal macrometastases.

, et al.. Long-term followup reveals that ulceration and sentinel lymph node status are the strongest predictors for survival in patients with primary cutaneous melanoma. EJSO -European Journal of Surgical Oncology, WB Saunders, 2011, 37 (8) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. 124 Patients (29%) relapsed during follow-up; 55 in the node-positive group who underwent CLND (55/119;46%) and 69 in the node-negative group (69/310;22%;p<0.001). In the node-negative group 17 patients developed recurrence in the regional node field; false-negative rate 11%.On multivariate analysis strongest prognostic factors for disease free survival (DFS) were primary melanoma ulceration and SLN positivity (Hazard Ratio (HR) of 2.2 and 2.3; p<0.001). For disease specific survival (DSS) the same was found to be true with a HR of 2.1 for ulceration and 2.0 for SLN positivity (p=0.001 and p=0.002 respectively). 10-Year DFS was 71% for node-negative patients compared with 48% for node-positive patients (p<0.001). 10-Year DSS was 77% for node-negative patients compared to 60% for node-positive patients (p<0.001).Conclusions: This study shows a remarkably high percentage of tumor-positive SLN. The long-term follow-up data confirm that tumor-positive SLN patients have a worse DFS and DSS than tumornegative SLN patients. Ulceration and SLN status proved to be the strongest prognostic factors for long-term DFS and DSS.

No abstract

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.