Outcome in 846 Cutaneous Melanoma Patients From a Single Center After a Negative Sentinel Node Biopsy

Yee, Vivian S. K.; Thompson, John F.; McKinnon, J. Gregory; Scolyer, Richard A.; Li, Ling-Xi L.; McCarthy, William H.; O’Brien, Christopher J.; Quinn, Michael J.; Saw, Robyn P.M.; Shannon, Kerwin F.; Stretch, Jonathan R.; Uren, Roger F.

doi:10.1245/aso.2005.03.074

Cited by 111 publications

(74 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rates of false-negative results in melanoma presently are about 10% (24)(25)(26). The lack of standard adjuvant therapy for melanoma could explain the difference between this disease and breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Visualization of Tumor Blockage and Rerouting of Lymphatic Drainage in Penile Cancer Patients by Use of SPECT/CT

Leijte¹,

Ploeg²,

Olmos³

et al. 2009

J Nucl Med

111

View full text Add to dashboard Cite

The reliability of sentinel node biopsy is dependent on the accurate visualization and identification of the sentinel node(s). It has been suggested that extensive metastatic involvement of a sentinel node can lead to blocked inflow and rerouting of lymph fluid to a ''neo-sentinel node'' that may not yet contain tumor cells, causing a false-negative result. However, there is little evidence to support this hypothesis. Recently introduced hybrid SPECT/ CT scanners provide both tomographic lymphoscintigraphy and anatomic detail. Such a scanner enabled the present study of the concept of tumor blockage and rerouting of lymphatic drainage in patients with palpable groin metastases. Methods: Seventeen patients with unilateral palpable and cytologically proven metastases in the groin underwent bilateral conventional lymphoscintigraphy and SPECT/CT before sentinel node biopsy of the contralateral groin. The pattern of lymphatic drainage in the 17 palpable groin metastases was evaluated for signs of tumor blockage or rerouting. Results: On the CT images, the palpable node metastases could be identified in all 17 groins. Four of the 17 palpable node metastases (24%) showed uptake of radioactivity on the SPECT/CT images. In 10 groins, rerouting of lymphatic drainage to a neo-sentinel node was seen; one neo-sentinel node was located in the contralateral groin. A complete absence of lymphatic drainage was seen in the remaining 3 groins. Conclusion: The concept of tumor blockage and rerouting was visualized in 76% of the groins with palpable metastases. Precise physical examination and preoperative ultrasound with fine-needle aspiration cytology may identify nodes with considerable tumor invasion at an earlier stage and thereby reduce the incidence of false-negative results.

show abstract

Section: Discussionmentioning

confidence: 99%

Visualization of Tumor Blockage and Rerouting of Lymphatic Drainage in Penile Cancer Patients by Use of SPECT/CT

Leijte¹,

Ploeg²,

Olmos³

et al. 2009

J Nucl Med

111

View full text Add to dashboard Cite

show abstract

“…Ulceration has previously been shown in a multivariate analysis to be an independent prognostic indicator of DFS in melanoma patients [10][11][12]; but in a study by van Akkoi et al, it did not remain an independent prognostic factor for OS after the multivariate analysis [20]. In a study of 309 melanoma patients subjected to SLND, Roka et al [12] reported that SN status (p<0.001), Breslow's thickness (p< 0.02), and ulceration (p<0.026) were all independent prognostic factors for DFS, whereas Breslow's thickness proved to be the only significant factor with respect to OS upon multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Ulceration of the primary melanoma has been reported by various authors to be a further prognostic indicator [10][11][12]. It has been shown that the presence of ulceration heralds a higher risk of metastases than in melanomas of equivalent thickness without ulceration, resulting in significantly lower survival rates, as shown by Balch et al [9].…”

Section: Introductionmentioning

confidence: 99%

Clinicopathologic prognostic markers of survival: an analysis of 259 patients with malignant melanoma ≥1 mm

et al. 2009

View full text Add to dashboard Cite

The histopathologic status of the sentinel node (SN) and the ulceration of the primary tumor are important indicators of the clinical outcome of melanoma patients. The purpose of this study was to investigate potential correlations between prognostic factors and the sentinel lymph node status as well as their influence on disease-free survival (DFS), distant metastases-free survival (DMFS), and overall survival (OS). The medical records of 259 melanoma patients who underwent sentinel lymph node dissection between 2000 and 2006 were analyzed. DFS, DMFS, and OS were assessed. A uni- and a multivariate analysis to determine prognostic factors were performed. Histologic type, Clark's level, and Breslow's tumor thickness were the only parameters that showed a significant correlation with a positive SN. The univariate analysis revealed SN positivity (DFS and DMFS: p < 0.001; OS: p = 0.039) and ulceration (DFS: p < 0.001; DMFS: p = 0.001; OS: p = 0.003) to be significant prognostic markers. However, ulceration was the only independent prognostic factor for OS that was upheld by the multivariate analysis (p = 0.006; HR 3.89; CI 1.48-10.27). In stage I/II melanoma patients, ulceration of the primary tumor was the strongest prognostic factor for RFS, DMFS, and OS and superior to the pathology status of the SN.

show abstract

“…The status of the regional lymph node basin is of paramount importance when the site of the primary melanoma is unknown. Yee et al [4] showed that melanoma-specific survival rate at 5 years was 90% for patients with a negative sentinel node, compared with 56% for sentinel node positive-patients when the patients' primary lesions were matched for depth of invasion.…”

Section: Discussionmentioning

confidence: 99%

Melanoma of unknown origin: a case series

Kelly

Redmond

2009

Ir J Med Sci

View full text Add to dashboard Cite

show abstract

Outcome in 846 Cutaneous Melanoma Patients From a Single Center After a Negative Sentinel Node Biopsy

Cited by 111 publications

References 30 publications

Visualization of Tumor Blockage and Rerouting of Lymphatic Drainage in Penile Cancer Patients by Use of SPECT/CT

Visualization of Tumor Blockage and Rerouting of Lymphatic Drainage in Penile Cancer Patients by Use of SPECT/CT

Clinicopathologic prognostic markers of survival: an analysis of 259 patients with malignant melanoma ≥1 mm

Melanoma of unknown origin: a case series

Contact Info

Product

Resources

About