Premium
A model for predicting low probability of nonsentinel lymph node positivity in melanoma patients with a single positive sentinel lymph node
Author(s) -
Bhutiani Neal,
Egger Michael E.,
Stromberg Arnold J.,
Gershenwald Jeffrey E.,
Ross Merrick I.,
Philips Prejesh,
Martin Robert C. G.,
Scoggins Charles R.,
McMasters Kelly M.
Publication year - 2018
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.25193
Subject(s) - medicine , sentinel lymph node , melanoma , lymph node , metastasis , adjuvant therapy , lymph , oncology , primary tumor , radiology , dissection (medical) , surgery , cancer , pathology , breast cancer , cancer research
Background Identifying factors associated with nonsentinel lymph node (NSN) metastases in melanoma patients with a single positive sentinel lymph node (SLN) could aid decision making regarding adjuvant therapy. We describe a model for identifying patients with a single positive SLN at low risk for NSN metastasis. Methods Factors associated with NSN metastasis in patients with a primary cutaneous melanoma and a single positive SLN who underwent completion lymph node dissection (CLND) were identified. These factors were used to construct a model for predicting the NSN status. The model was validated using a separate data set from another tertiary referral cancer center. Results In the training data set, 111 patients had a single positive SLN. Of these, 27 had positive NSN. SLN tumor deposit diameter ≥0.75 mm (OR, 3.43; P = 0.047), age ≥40 (OR, 12.14; P = 0.024), and multifocal SLN tumor deposit location (OR, 4.16; P = 0.0096) were independently associated with NSN positivity. Patients with 0 to 1 of these risk factors had a low risk of NSN metastasis in both the training (7.5%) and validation (4.6%) data sets. Conclusions A combination of patient and SLN tumor burden characteristics can help to identify patients with a single positive SLN who are at a low risk of NSN metastasis.