Micrometastasis of a Sentinel Lymph Node in Cutaneous Melanoma Is a Significant Prognostic Factor for Disease-Free Survival, Distant-Metastasis-Free Survival, and Overall Survival

Abstract

The study examined patients with melanomas of all tumor thicknesses and SLNB for which the prognostic significance of SLNB was tested. Recurrences were more frequent in patients with a micrometastatic SLN. Patients with a negative SNLB are still at risk for tumor recurrence. The histopathologic result of SLNB is, after tumor thickness, the most significant prognostic factor for disease-free survival, distant-metastasis-free survival, and overall survival.

Prognostic risk factors of first recurrence in patients with primary stages I–II cutaneous malignant melanoma – from the population‐based Swedish melanoma register

“…The results in this study are only valid for patients without information of SNB or patients with a negative SNB. A positive SNB significantly increases the risk of recurrence . A recent large population‐based study from Sweden also showed that the risk of dying from CMM was three times higher after a positive SNB compared to a negative SNB …”

“…A worse prognosis in patients with localized primary CMM is related to increasing age, male sex, nodular histogenetic type, increasing tumour thickness, presence of tumour ulceration and also presence of mitoses in T1 CMM . However, few studies have used multivariable analyses to identify prognostic risk factors for first recurrence, including locoregional and distant metastases in stages I‐II CMM patients . Most previous studies have used selected hospital‐based data, but only one has used population‐based data .…”

“…3,[5][6][7][8][9] However, few studies have used multivariable analyses to identify prognostic risk factors for first recurrence, including locoregional and distant metastases in stages I-II CMM patients. [10][11][12] Most previous studies have used selected hospital-based data, but only one has used population-based data. 10 Population-based analyses would demonstrate an unbiased proportion of recurrences and the CMM-specific survival and be of importance in planning customized follow-up strategies for different groups of CMM patients.…”

Impact of nodal status and tumor burden in sentinel lymph nodes on the clinical outcomes of cancer patients

“…The S‐classification is highly reliable with the prediction of positivity of non‐SLNs and clinical outcome with S0 and SI being the most favorable groups. Other studies have also demonstrated that micrometastasis in melanoma SLNs is clinically significant 15–22. In a prospective randomized Multicenter Selective Lymphadenectomy Trial I, 1,269 patients with primary cutaneous melanoma were randomized to wide excision and observation with lymph node dissection of the nodal basin only when recurrence was noted in the nodal basin versus wide excision and selective sentinel lymphadenectomy followed by completion lymph node dissection when the SLNs were positive.…”

Intraoperative labeling of sentinel lymph nodes with a combination of vital dye and radionuclide tracer – results in sentinel lymph node‐positive patients

“…Due to its direct lymphatic connection with the primary tumor, the SLN will most probably filter the first tumor cells to metastasize via lymphatics. The presence or absence of lymph node metastases is one of the most significant prognostic factors for melanoma patients, underscoring the importance of diagnostic lymphadenectomy [2–4]. Numerous studies have shown that the selective dissection of the SLN allows more accurate tumor staging in melanoma [2, 5–7].…”