Does sentinel lymph node status have prognostic significance in patients with acral lentiginous melanoma?. Issue 8 (18th March 2019)

• Record Type: Journal Article
• Authors: Pavri, Sabrina N.; Han, Gang; Khan, Sajid; Han, Dale
• Is Part Of: Journal of surgical oncology. Volume 119:Issue 8(2019)
• Page Start: 1060
• Page End: 1069
• Publication Date: 2019-03-18
• Subjects: metastasis -- nodal positivity -- survival; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.25445
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Background: The prognostic benefit of sentinel lymph node biopsy (SLNB) and factors predictive of survival specifically in patients with acral lentiginous melanoma (ALM) are unknown. Methods: The SEER database was queried for ALM cases that underwent SLNB from 1998 to 2013. Clinicopathological factors were correlated with SLN status, overall survival (OS), and melanoma‐specific survival (MSS). Results: Median age for the 753 ALM study patients was 65 years, and 48.2% were male. Median thickness was 2 mm with 38.1% of cases having ulceration. SLN metastases were detected in 194 of 753 cases (25.7%). Multivariable analysis showed that thickness, Clark level IV‐V, and ulceration significantly predicted for SLN metastasis ( P < 0.05). For patients with positive SLN, 5‐year OS and MSS were significantly worse at 48.1% and 58.9%, respectively, compared with 78.7% and 88.5%, respectively, for patients with negative SLN ( P < 0.0001). On multivariable analyses, older age, male gender, increasing thickness, ulceration, and a positive SLN significantly predicted for worse OS and MSS (all P < 0.05). Conclusion: This study confirms the important role of SLNB in ALM. SLN metastases are seen in 25.7% of ALM cases, providing significant prognostic information. In addition, thickness, ulceration status, and SLNB status significantly predict survival in patients with ALM.