Trial reportAnnals of surgical oncology2014
Clark level risk stratifies patients with mitogenic thin melanomas for sentinel lymph node biopsy.
Trial report in Annals of surgical oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictive Values of Pathological and Clinical Risk Factors for Positivity of Sentinel Lymph Node Biopsy in Thin Melanoma: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2022Pooled it
- Invasive Cutaneous Melanoma: Evaluating the Prognostic Significance of Some Parameters Associated with Lymph Node Metastases.Medicina (Kaunas, Lithuania) · 2023Article
- The Evolution of the Sentinel Node Biopsy in Melanoma.Life (Basel, Switzerland) · 2023Review
- Article
- Use and Costs of Sentinel Lymph Node Biopsy in Non-Ulcerated T1b Melanoma: Analysis of a Population-Based Registry.Annals of surgical oncology · 2021Article
- Re-evaluation of Sentinel Lymph Node Biopsy for Melanoma.Current treatment options in oncology · 2021Review
- Sentinel Lymph Node Biopsy for T1b Melanoma: Balancing Prognostic Value and Cost.Annals of surgical oncology · 2020Article
- Survival analysis and sentinel lymph node status in thin cutaneous melanoma: A multicenter observational study.Cancer medicine · 2019Observational
- Current management of regional lymph nodes in patients with melanoma.Journal of surgical oncology · 2019Review
- Association Between Patient Age and Lymph Node Positivity in Thin Melanoma.JAMA dermatology · 2017Article
- Thin Melanoma with Nodal Involvement: Analysis of Demographic, Pathologic, and Treatment Factors with Regard to Prognosis.Annals of surgical oncology · 2017Article
- Acral Lentiginous Histologic Subtype and Sentinel Lymph Node Positivity in Thin Melanoma.JAMA dermatology · 2016Article
- Clinical utilities and biological characteristics of melanoma sentinel lymph nodes.World journal of clinical oncology · 2016Review
- Identification of Patients with Intermediate Thickness Melanoma at Low Risk for Sentinel Lymph Node Positivity.Annals of surgical oncology · 2016Article
- EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma.European journal of nuclear medicine and molecular imaging · 2015Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundThe role for sentinel lymph node biopsy (SLNB) in patients with thin melanoma (≤1 mm) remains controversial. We examined a large cohort of patients with thin melanoma to better define predictors of SLN positivity.
methodsFrom 1995 to 2011, 781 patients with thin primary melanoma and evaluable clinicopathologic data underwent SLNB at our institution. Predictors of SLN positivity were determined using univariate and multivariate regression analyses, and patients were risk-stratified using a classification and regression tree (CART) analysis.
resultsIn the study cohort (n = 781), 29 patients (3.7%) had nodal metastases. In the univariate analysis, mitotic rate [odds ratio (OR) = 8.11, p = 0.005], Clark level (OR 4.04, p = 0.003), and thickness (OR 3.33, p = 0.011) were significantly associated with SLN positivity. In the multivariate analysis, MR (OR 7.01) and level IV-V (OR 3.45) remained significant predictors of SLN positivity. CART analysis initially stratified lesions by mitotic rate; nonmitogenic lesions (n = 273) had a 0.7% SLN positivity rate versus 5.6% in mitogenic lesions (n = 425). Mitogenic lesions were further stratified by Clark level; patients with level II-III had a 2.9% SLN positivity rate (n = 205) versus 8.2% with level IV-V (n = 220). With median follow-up of 6.3 years, five SLN-negative patients developed nodal recurrence and four SLN-positive patients died of disease.
conclusionsSLN positivity is low in patients with thin melanoma (3.7%) and exceedingly so in nonmitogenic lesions (0.7%). Appreciable rates of SLN positivity can be identified in patients with mitogenic lesions, particularly with concurrent level IV-V regardless of thickness. These factors may guide appropriate selection of patients with thin melanoma for SLNB.
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