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Clinical significance of the RT‐PCR positive sentinel node in melanoma
Author(s) -
Temple C.L.F.,
Snell L.J.,
Power S.M.,
Parfitt J.R.,
Scilley C.,
Engel C.J.,
Shum D.,
Chakrabarti S.,
Joseph M.G.,
Lohmann R.C.,
Ainsworth P.
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20741
Subject(s) - medicine , sentinel node , melanoma , odds ratio , immunohistochemistry , clinical significance , histology , gastroenterology , pathology , h&e stain , oncology , cancer , breast cancer , cancer research
Background The clinical relevance of RT‐PCR positivity for melanoma markers in the sentinel node remains controversial. Our purpose was to determine whether patients with a histologically negative but RT‐PCR positive node were at an increased risk for recurrence than their RT‐PCR negative counterparts. Methods Thirty‐nine adult patients underwent sentinel node biopsies for melanoma between 1998 and 2000. Each sentinel node was bivalved. Half was serially sectioned and examined by routine hematoxylin and eosin (H&E) and immunohistochemistry (IHC; S100, HMB‐45, melanA, and tyrosinase). The other half was analyzed by a nested RT‐PCR assay for tyrosinase. Results Patients were followed for recurrence with a mean follow‐up of 71.1 months. The odds ratio of recurrence for RT‐PCR positive versus RT‐PCR negative patients was 1.39 (0.34, 5.62; p = 0.73). Within the histology negative subgroups, the risk of recurrence in the RT‐PCR positive group (26.7%) was not significantly different from the risk of recurrence in the RT‐PCR negative group (22.2%) ( p = 0.33 chi‐squared). RT‐PCR of the sentinel node was not a predictor for recurrence on multivariate analysis ( p = 0.65). Conclusion Sentinel node RT‐PCR positivity did not risk stratify histologically negative melanoma patients beyond routine pathologic examination in this series. J. Surg. Oncol. 2007;95:546–554. © 2007 Wiley‐Liss, Inc.