To What Extent Does Metastasis Within the Sentinel Node Affect Survival?
To What Extent Does Metastasis Within the Sentinel Node Affect Survival?
van Akkooi AC, Nowecki ZI, Voit C, et al
Ann Surg. 2008;248:949-955
This study evaluated survival in patients with sentinel node-positive melanoma using information from a multicenter study. Three European centers combined data from 388 patients with sentinel node-positive melanoma to study survival in relation to the burden of melanoma within the sentinel node. Breslow thickness was a strong predictor of survival, but the most important survival factor was the extent of metastatic disease within the sentinel node. Overall survival in patients with micrometastatic disease (< 0.1 mm) was nearly identical to patients with node-negative disease. In patients with metastatic sentinel node disease measuring > 0.1 mm, the mortality rate was 4-5 times greater than in patients with micrometastases.
This study had sufficient power to state conclusively that patients with small deposits of melanoma cells in sentinel nodes (< 0.1 mm) have the same survival rates as patients with node-negative melanoma. These results suggest that this subgroup of patients can be regarded as node-negative and will not benefit from node dissection. An intriguing question concerns the fate of these small melanoma deposits: Are they destroyed, or do they persist but remain quiescent?
Abstract
van Akkooi AC, Nowecki ZI, Voit C, et al
Ann Surg. 2008;248:949-955
This study evaluated survival in patients with sentinel node-positive melanoma using information from a multicenter study. Three European centers combined data from 388 patients with sentinel node-positive melanoma to study survival in relation to the burden of melanoma within the sentinel node. Breslow thickness was a strong predictor of survival, but the most important survival factor was the extent of metastatic disease within the sentinel node. Overall survival in patients with micrometastatic disease (< 0.1 mm) was nearly identical to patients with node-negative disease. In patients with metastatic sentinel node disease measuring > 0.1 mm, the mortality rate was 4-5 times greater than in patients with micrometastases.
This study had sufficient power to state conclusively that patients with small deposits of melanoma cells in sentinel nodes (< 0.1 mm) have the same survival rates as patients with node-negative melanoma. These results suggest that this subgroup of patients can be regarded as node-negative and will not benefit from node dissection. An intriguing question concerns the fate of these small melanoma deposits: Are they destroyed, or do they persist but remain quiescent?
Abstract
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