TY  - BOOK
AU  - Venna, Suraj S
TI  - Analysis of sentinel lymph node positivity in  patients with thin primary melanoma
SN  - 0190-9622
PY  - 2013///
KW  - *Melanoma/pa [Pathology]
KW  - *Sentinel Lymph Node Biopsy
KW  - *Skin Neoplasms/pa [Pathology]
KW  - Adult
KW  - Female
KW  - Humans
KW  - Male
KW  - Prognosis
KW  - Washington Cancer Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 -  present, Available in print through MWHC library: 1999 -  2006
N2  - BACKGROUND: A minority of patients with T1  melanoma will have a positive sentinel lymph node (SLN)  biopsy (SLNB) finding. Identifying who will develop  metastatic disease is important in determining prognosis and  treatment; CONCLUSIONS: Combining clinical and histologic  prognostic factors may help identify subgroups of T1  patients at higher risk of SLN positivity. SLN status has  significant prognostic impact in patients with thin  melanomas. Copyright  2012 American Academy of Dermatology,  Inc. Published by Mosby, Inc. All rights reserved; LIMITATIONS: Our data analysis includes patients  from 1994 to 2007 and therefore information on mitotic rate,  a recently defined T1b criterion, is not recorded for all  patients; METHODS: Clinical and histologic parameters were  evaluated in 484 patients with T1 melanoma for their ability  to predict a positive SLNB result. The impact of various  factors on SLN positivity was evaluated. SLN status was  examined as a predictor of overall survival; OBJECTIVE: We sought to identify clinical and  histologic features predictive of a positive SLNB result and  determine its prognostic significance in patients with T1  melanoma; RESULTS: In all, 34 patients had a positive SLNB  finding. Four factors predicted a higher risk of SLN  positivity: age 43 years or younger, Breslow depth 0.8 mm or  greater, tumors on the lower extremity and trunk, and  tumor-infiltrating lymphocyte level. By multivariate  analysis, low tumor-infiltrating lymphocytes (P = .0015) and  decreasing age (P = .0058) independently predicted SLN  positivity. If 0 to 2 of these factors were present, the  rate of a positive SLNB result was 3%; this increased to 15%  with 3 factors present and to 30% if all 4 factors were  present (P < .002). SLN-positive patients had significantly  decreased survival (P = .003), and SLN status was the most  powerful predictor of survival (P = .009)
UR  - http://dx.doi.org/10.1016/j.jaad.2012.08.045
ER  -