Abstract
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.
Original language | English (US) |
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Pages (from-to) | 922-927 |
Number of pages | 6 |
Journal | Journal of surgical oncology |
Volume | 118 |
Issue number | 6 |
DOIs | |
State | Published - Nov 1 2018 |
Keywords
- cutaneous melanoma
- nonsentinel lymph nodes
- predictive model
- sentinel lymph node (SLN) positive melanoma
ASJC Scopus subject areas
- Surgery
- Oncology