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No non‐sentinel node involvement in melanoma patients with limited Breslow thickness and low sentinel node tumour load
Author(s) -
Bogenrieder Thomas,
van Dijk Marijke R,
Blokx Willeke A M,
Ramrath Katrin,
Seldenrijk Kees,
Stolz Wilhelm,
van Diest Paul J
Publication year - 2011
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2011.03931.x
Subject(s) - medicine , melanoma , breslow thickness , sentinel node , dissection (medical) , lymph node , lymph , radiology , sentinel lymph node , pathology , cancer , cancer research , breast cancer
Bogenrieder T, van Dijk M R, Blokx W A M, Ramrath K, Seldenrijk K, Stolz W & van Diest P J
(2011) Histopathology 59 , 318–326 No non‐sentinel node involvement in melanoma patients with limited Breslow thickness and low sentinel node tumour load Aims: Most melanoma patients with a positive sentinel node (SN) undergo completion lymph node dissection and frequently experience associated morbidity. However, only 10–30% of SN‐positive patients have further lymph node metastases. The aim of the present study was to predict the absence of non‐SN metastases in a multicentre study of patients with a positive SN based on primary melanoma features and SN tumour load. Methods and results: Of 70 SN positive patients, 18 had non‐SN metastases. Penetrative depth of metastatic cells into the SN and SN tumour load was assessed by morphometry. None of the 14 patients (20%) with a Breslow thickness <2.0 mm and an SN tumour load <0.2 mm 2 had non‐SN metastases. Similarly, none of the 15 patients (21%) with a Breslow thickness <2.0 mm and SN penetrative depth <600 μm had non‐SN metastases. Lastly, none of the 14 patients (20%) with a Breslow thickness <2.0 mm and a diameter of the largest SN deposit <500 μm had non‐SN metastases. Conclusions: A combination of limited Breslow thickness and low SN tumour load predicts absence of non‐SN metastases in melanoma patients with a positive SN with high accuracy. We propose that this subgroup may be spared completion lymph node dissection.