T2 melanoma: young age, LVI among predictors of SLN metastasis

  • Egger ME & al.
  • Ann Surg Oncol
  • 7 Aug 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Younger age, lymphovascular invasion (LVI), mitotic rate, thickness, location, and Clark level are associated with sentinel lymph node (SLN) metastasis in patients with T2 melanoma.

Why this matters

  • Accurate prediction of metastasis risk can help avoid unnecessary SLN biopsy, particularly among elderly patients with low-risk disease.

Key results

  • Increasing thickness (OR, 1.009; P<.0001 lvi p mitotic rate>2 (OR, 1.77; P<.0001 and clark level p=".0046)" were associated with sln metastasis in multivariate analysis.>
  • Older age (OR, 0.977; P<.0001 and extremity location p=".0010" vs axial were inversely associated.>
  • Patients aged >56 years with no LVI had 7.8% risk (95% CI, 7.2%-8.4%) for SLN metastasis.
    • This group comprised 60% of the patients in the data set.
  • Patients aged ≤56 years had 14.5% risk (95% CI, 13.6%-15.6%) of SLN metastasis.
  • Patients aged >56 years with LVI had 26.0% risk (95% CI, 20.4%-32.2%) of SLN metastasis.
  • Patients aged >75 years and no LVI with melanoma ≤1.2 mm had 4.9% risk (95% CI, 3.3%-7.1%) of SLN metastasis.
  • Study design

    • 12,918 patients with clinically node-negative T2 melanoma who underwent SLN biopsy from the National Cancer Database were included.
    • Funding: None disclosed.

    Limitations

    • Observational study of large database.