Prognostic Importance of Lymph Node Tumor Burden in Melanoma Patients Staged by Sentinel Node Biopsy

Sentinel lymph node biopsy in melanoma: a micromorphometric study relating to prognosis and completion lymph node dissection

“…According to our study, although several parameters were associated with shorter disease-free and disease-specific survivals, few remained independently significant by multivariate analysis: the presence of an extracapsular invasion for diseasefree survival and both the maximum diameter of the largest metastasis and the presence of an ulceration of the primary melanoma for disease-specific survival. These results are concordant with the conclusions of Ranieri et al 13 and Cochran et al 14 that the tumour burden was predictive of survival. However, Ranieri et al 13 found that ulceration had no impact on the prognosis.…”

“…These results are concordant with the conclusions of Ranieri et al 13 and Cochran et al 14 that the tumour burden was predictive of survival. However, Ranieri et al 13 found that ulceration had no impact on the prognosis. Our study is the first to point out such a correlation.…”

“…Ranieri et al 13 drew the conclusion that the maximum diameter of the largest SLN tumour deposit was associated with outcome: the cut-off point of 3 mm appeared to be particularly relevant with regard to 5-year disease-free and overall survival by multivariate analysis.…”

Factors Associated With Improved Survival Among Young Adult Melanoma Patients Despite a Greater Incidence of Sentinel Lymph Node Metastasis

“…There could be an increased rate of false negative SLN results or a decreased sensitivity in detection of SLN in older patients, although the low level of locoregional recurrence in nodal basins previously determined to be SLN negative seems to suggest an alternative explanation. Perhaps there is an increased rate of hematogenous spread in older patients or a greater tumor burden per positive SLN [7,[17][18][19]. We have observed no differences in IHC-only detected SLN metastases between the two age groups.…”

Melanoma staging: Evidence‐based changes in the American Joint Committee on Cancer eighth edition cancer staging manual

“…There is significant and growing evidence that microscopic tumor burden in the SLN is prognostically important. [78][79][80][81][82][83][84][85][86][87][88][89][90] SLN tumor burden can be assessed by a variety of micromorphometric parameters, including the maximum size of the largest metastasis, the maximum subcapsular depth (also known as tumor penetrative depth 88 of the deposits and measured from the inner surface of the lymph node capsule to the deepest intranodal tumor cell), the microanatomic location of SLN tumor deposits, the percentage crosssectional area of the SLN that is involved, and the presence of extranodal extension. In various studies, one or more of these parameters has predicted survival in SLN-positive patients.…”