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Cutaneous melanoma growth rate helped to predict sentinel lymph node positivity
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The growth rate of cutaneous melanoma, along with Breslow thickness and the presence of microscopic satellitosis, predicted patients’ histological sentinel lymph node positivity in a recent study.
Investigators conducted a retrospective cohort study of 698 patients with invasive primary cutaneous melanoma based upon database selections from two hospitals in Spain. Each patient had a single primary melanoma and clinical stage I or stage II disease and underwent selective sentinel lymph node (SLN) biopsy between Jan. 1, 2000 and June 30, 2010. The median age of the patients in the study was 53 years, and the cohort included 355 women.
In 102 patients (20.2%), SLN was positive. Multivariate logistic regression analysis showed that growth rate (GR), Breslow thickness, and microscopic satellitosis were associated independently with SLN positivity. Upon SLN biopsy positivity, the probability for fast-growth melanomas (>0.50 mm/month) in patients was greater (37.7%) compared with patients with intermediate-growth melanomas (0.10-0.50 mm/month; 19.8%) and those with slow-growth melanomas (<0.10 mm/month; 8.2%).
Researchers also said SLN positivity was the most critical prognostic factor for disease-free survival (DFS) (HR=2.13; 95% CI, 1.20-3.76) and overall survival (OR) (HR=3.99; 95% CI, 1.67-9.53). Five-year DFS was 50% for patients with positive SLN, compared with 84.4% for patients with SLN negativity (P<.001). Five-year OS was 73% for patients with SLN positivity; 92.1% for those with SLN negativity (P<.001).
“The most relevant finding … is that GR of primary cutaneous melanoma, together with Breslow thickness and the presence of microscopic satellitosis, predicts SLN positivity,” the researchers concluded. “SLN positivity is considered the principal prognostic factor for DFS and OS.”
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