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Age, Sentinel Lymph Node Risk Link in Melanoma

J Am Acad Dermatol; ePub 2018 Aug 27; Hanna, et al

Patient age is an important factor in estimating sentinel lymph node (SLN) risk in patients with intermediate thickness melanoma (ITM) and may help identify patients without ulceration that may be safely spared a SLN biopsy. This according to a recent study that aimed to identify a group of ITM patients for whom risk of nodal disease is low. A retrospective cohort of ITM patients who underwent wide excision and nodal evaluation from 2010 to 2013 using the National Cancer Database was analyzed for the presence of nodal disease. Classification and regression tree (CART) analysis identified the most important factors used in a model to identify low risk groups of SLN positivity. Researchers found:

  • Of 23,440 patients, 14.7% were found to have nodal metastasis.
  • On CART analysis, patients aged >55 years without lymphovascular invasion and lesion thickness < 1.7 mm had a SLN positivity rate of 4.9%.
  • A model using age and thickness in non-ulcerated patients identified a low risk subgroup with a corresponding SLN positivity rate of 4.7%.

Citation:

Hanna AN, Sinnamon AJ, Roses RE, et al. Relationship between age and likelihood of lymph node metastases in patients with intermediate thickness melanoma (1.01 - 4.00 mm): A National Cancer Database study. [Published online ahead of print August 27, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.08.022.