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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 13/2016

01.03.2016 | Melanomas

Sentinel Lymph Node Biopsy in Thin Cutaneous Melanoma: A Systematic Review and Meta-Analysis

verfasst von: Erin Cordeiro, MD, MSc, FRCSC, Mai-Kim Gervais, MD, FRCSC, Prakesh S. Shah, MD, MSc, FRCPC, Nicole J. Look Hong, MD, MSc, FRCSC, Frances C. Wright, MD, MEd, FRCSC

Erschienen in: Annals of Surgical Oncology | Ausgabe 13/2016

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Abstract

Background

Most patients with melanoma have a thin (≤1.00 mm) lesion. There is uncertainty as to which patients with thin melanoma should undergo sentinel lymph node (SN) biopsy. We sought to quantify the proportion of SN metastases in patients with thin melanoma and to determine the pooled effect of high-risk features of the primary lesion on SN positivity.

Methods

Published literature between 1980 and 2015 was searched and critically appraised. Primary outcome was the proportion of SN metastases in patients with thin cutaneous melanoma. Secondary outcomes included the effect of high-risk pathological features of the primary lesion on the proportion of SN metastases. Summary measures were estimated by Mantel–Haenszel method using random effects meta-analyses.

Results

Sixty studies (10,928 patients) met the criteria for inclusion. Pooled SN positivity was 4.5 % [95 % confidence interval (CI) 3.8–5.2 %]. Predictors of a positive SN were: thickness ≥0.75 mm [adjusted odds ratio (AOR) 1.90 (95 % CI 1.08–3.34); with a likelihood of SN metastases of 8.8 % (95 % CI 6.4–11.2 %)]; Clark level IV/V [AOR 2.24 (95 % CI 1.23–4.08); with a likelihood of 7.3 % (95 % CI 6.2–8.4 %)]; ≥1 mitoses/mm2 [AOR 6.64 (95 % CI 2.77–15.88); pooled likelihood 8.8 % (95 % CI 6.2–11.4 %)]; and the presence of microsatellites [unadjusted OR 6.94 (95 % CI 2.13–22.60); likelihood 26.6 % (95 % CI 4.3–48.9 %)].

Conclusions

The pooled proportion of SN metastases in thin melanoma is 4.5 %. Thickness ≥0.75 mm, Clark level IV/V, mitoses, and microsatellites significantly increased the odds of SN positivity and should prompt strong consideration of SN biopsy.
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Literatur
1.
2.
Nikolaou, V, Stratigos AJ. Emerging trends in the epidemiology of melanoma. Br J Dermatol. 2014;170(1):11–9.CrossRefPubMed
3.
Gimotty PA, et al. Thin primary cutaneous malignant melanoma: a prognostic tree for 10-year metastasis is more accurate than American Joint Committee on Cancer staging. J Clin Oncol. 2004;22(18):3668–76.CrossRefPubMed
4.
McKinnon JG, et al. Prognosis for patients with thin cutaneous melanoma: long-term survival data from New South Wales Central Cancer Registry and the Sydney Melanoma Unit. Cancer. 2003;98(6):1223–31.CrossRefPubMed
5.
6.
Valsecchi ME, et al. Lymphatic mapping and sentinel lymph node biopsy in patients with melanoma: a meta-analysis. J Clin Oncol. 2011;29(11):1479–87.CrossRefPubMed
7.
Morton DL, et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med. 2006;355(13):1307–17.CrossRefPubMed
8.
Wrightson WR, et al. Complications associated with sentinel lymph node biopsy for melanoma. Ann Surg Oncol. 2003;10(6):676–80.CrossRefPubMed
9.
Coit DG, et al. Melanoma, version 4.2014: featured updates to the NCCN guidelines. JNCCN J Natl Compr Cancer Netw. 2014;12(5):621–9.
10.
Wong SL, et al. Sentinel lymph node biopsy for melanoma: American Society of Clinical Oncology and Society of Surgical Oncology Joint Clinical Practice guideline. J Clin Oncol. 2012;30(23):2912–8.CrossRefPubMed
11.
Dummer R, et al. Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23(7):vii86–91.PubMed
12.
Roberts DL, et al. U.K. guidelines for the management of cutaneous melanoma. Br J Dermatol. 2002;146(1):7–17.CrossRefPubMed
13.
Bartlett EK, et al. Clark level risk stratifies patients with mitogenic thin melanomas for sentinel lymph node biopsy. Ann Surg Oncol. 2014;21(2):643–9.CrossRefPubMed
14.
Karakousis GC, et al. Predictors of regional nodal disease in patients with thin melanomas. Ann Surg Oncol. 2006;13(4):533–41.CrossRefPubMed
15.
Kaur C, et al. The correlation of regression in primary melanoma with sentinel lymph node status. J Clin Pathol. 2008;61(3):297–300.CrossRefPubMed
16.
Kesmodel SB, et al. Mitotic rate as a predictor of sentinel lymph node positivity in patients with thin melanomas. Ann Surg Oncol. 2005;12(6):449–58.CrossRefPubMed
17.
Yonick DV, et al. Predictors of positive sentinel lymph node in thin melanoma. Am J Surg. 2011;201(3):324–7 (Discussion 327–8).
18.
Ribas A, et al. Pembrolizumab versus investigator-choice chemotherapy for ipilimumab-refractory melanoma (KEYNOTE-002): a randomised, controlled, phase 2 trial. Lancet Oncol. 2015;16(8):908–18.CrossRefPubMed
19.
Larkin J, et al. Vemurafenib in patients with BRAF(V600) mutated metastatic melanoma: an open-label, multicentre, safety study. Lancet Oncol. 2014;15(4):436–44.CrossRefPubMed
20.
21.
22.
23.
Han D, et al. Clinicopathologic predictors of sentinel lymph node metastasis in thin melanoma. J Clin Oncol. 2013;31(35):4387–93.CrossRefPubMed
24.
Jaber JJ, et al. Evolving treatment strategies in thin cutaneous head and neck melanoma: one institution’s experience. Head Neck. 2011;33(1):7–12.CrossRefPubMed
25.
Balch CM, et al. Age as a predictor of sentinel node metastasis among patients with localized melanoma: an inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients. Ann Surg Oncol. 2014;21(4):1075–81.CrossRefPubMedPubMedCentral
26.
Cafiero F, et al. The role of sentinel lymph node biopsy in patients with stage I/II cutaneous melanoma: the clinical experience at the National Cancer Research Institute of Genoa, Italy. Tumori. 2002;88(3):S55–6.PubMed
27.
Doumas A, et al. Is 0.75-mm Breslow thickness the right cut-off point for performing sentinel node biopsy in patients with melanoma? Eur J Nucl Med Mol Imaging. 2010;37:S442–3.
28.
Murali R, et al. Sentinel lymph node biopsy in patients with thin primary cutaneous melanoma. Ann Surg. 2012;255(1):128–33.CrossRefPubMed
29.
Nahabedian MY, Tufaro AP, Manson PN. Sentinel lymph node biopsy for the T1 (thin) melanoma: is it necessary? Ann Plast Surg. 2003;50(6):601–6.CrossRefPubMed
30.
Venna SS, et al. Analysis of sentinel lymph node positivity in patients with thin primary melanoma. J Am Acad Dermatol. 2013;68(4):560–7.CrossRefPubMed
31.
Sperry SM, Charlton ME, Pagedar NA. Association of sentinel lymph node biopsy with survival for head and neck melanoma: survival analysis using the SEER database. JAMA Otolaryngol Head Neck Surg. 2014;140(12):1101–9.CrossRefPubMedPubMedCentral
32.
33.
Review Manager (2014) The Nordic cochrane center. The Cochrane Collaboration, Copenhagen.
34.
Wallace BC, et al. OpenMetaAnalyst: closing the gap between methodologists and end-users: R as a computational back-end. J Stat Softw 2012;49:1–15.CrossRef
35.
McMasters KM, et al. Lessons learned from the Sunbelt Melanoma Trial. J Surg Oncol. 2004;86(4):212–23.CrossRefPubMed
36.
Rossi CR, et al. Number of excised lymph nodes as a quality assurance measure for lymphadenectomy in melanoma. JAMA Surg. 2014;149(7):700–6.CrossRefPubMed
37.
Rossi CR, et al. The number of excised lymph nodes is associated with survival of melanoma patients with lymph node metastasis. Ann Oncol. 2014;25(1):240–6.CrossRefPubMed
38.
Mitteldorf C, et al. Sentinel node biopsy improves prognostic stratification in patients with thin (pT1) melanomas and an additional risk factor. Ann Surg Oncol. 2014;21(7):2252–8.CrossRefPubMed
39.
Warycha M, et al. Metaanalysis of sentinel lymph node positivity in thin melanoma (<1 mm). J Am Acad Dermatol. 2009;1:AB10.
40.
Cascinelli N, et al. Sentinel lymph node biopsy in cutaneous melanoma: the WHO Melanoma Program experience. Ann Surg Oncol. 2000;7(6):469–74.CrossRefPubMed
41.
Ishihara T, et al. Sentinel lymph nodes study in 30 cases of melanoma. J Dermatol. 2001;28(7):347–52.CrossRefPubMed
42.
Nguyen CL, et al. Melanoma thickness and histology predict sentinel lymph node status. Am J Surg. 2001;181(1):8–11.CrossRefPubMed
43.
Muller S, et al. No indication for performing sentinel node biopsy in melanoma patients with a Breslow thickness of less than 0.9 mm. Melanoma Res. 2001;11(3):303–7.CrossRef
44.
Agnese DM, et al. Cost-effectiveness of sentinel lymph node biopsy in thin melanomas. Surgery. 2003;134(4):542–8.CrossRefPubMed
45.
Evans HL, et al. Lymphoscintigraphy and sentinel node biopsy accurately stage melanoma in patients presenting after wide local excision. Ann Surg Oncol. 2003;10(4):416–25.CrossRefPubMed
46.
Jacobs IA, et al. Role of sentinel lymph node biopsy in patients with thin (<1 mm) primary melanoma. Ann Surg Oncol. 2003;10(5):558–61.CrossRefPubMed
47.
Lowe JB, et al. Sentinel lymph node biopsy in patients with thin melanoma. Arch Dermatol. 2003;139(5):617–21.CrossRefPubMed
48.
Nowecki ZI, et al. Sentinel lymph node biopsy in melanoma patients with clinically negative regional lymph nodes: one institution’s experience. Melanoma Res. 2003;13(1):35–43.CrossRefPubMed
49.
Oliveira Filho RS, et al. Vertical growth phase and positive sentinel node in thin melanoma. Braz J Med Biol Res. 2003;36(3):347–50.
50.
Rousseau DL Jr, et al. Revised American Joint Committee on Cancer staging criteria accurately predict sentinel lymph node positivity in clinically node-negative melanoma patients. Ann Surg Oncol. 2003;10(5):569–74.CrossRefPubMed
51.
Chakera AH, et al. Sentinel node biopsy for melanoma: a study of 241 patients. Melanoma Res. 2004;14(6):521–6.CrossRefPubMed
52.
Moehrle M, et al. Micrometastasis of a sentinel lymph node in cutaneous melanoma is a significant prognostic factor for disease-free survival, distant-metastasis-free survival, and overall survival. Dermatol Surg. 2004;30(10):1319–28.PubMed
53.
Sondak VK, et al. Mitotic rate and younger age are predictors of sentinel lymph node positivity: lessons learned from the generation of a probabilistic model. Ann Surg Oncol. 2004;11(3):247–58.CrossRefPubMed
54.
Stitzenberg KB, et al. Indications for lymphatic mapping and sentinel lymphadenectomy in patients with thin melanoma (Breslow thickness ≤1.0 mm). Ann Surg Oncol. 2004;11(10):900–6.CrossRefPubMed
55.
Berk DR, et al. Sentinel lymph node biopsy for cutaneous melanoma: the Stanford experience, 1997–2004. Arch Dermatol. 2005;141(8):1016–22.CrossRefPubMed
56.
Puleo CA, et al. Sentinel node biopsy for thin melanomas: which patients should be considered? Cancer Control. 2005;12(4):230–5.PubMed
57.
Rex J, et al. Single-institution experience in the management of patients with clinical stage I and II cutaneous melanoma: results of sentinel lymph node biopsy in 240 cases. Dermatol Surg. 2005;31(11 Pt 1):1385–93.PubMed
58.
Roka F, et al. Sentinel node status in melanoma patients is not predictive for overall survival upon multivariate analysis. Br J Cancer. 2005;92(4):662–7.CrossRefPubMedPubMedCentral
59.
Cascinelli N, et al., Sentinel and nonsentinel node status in stage IB and II melanoma patients: two-step prognostic indicators of survival. J Clin Oncol. 2006;24(27):4464–71.CrossRefPubMed
60.
Lock-Andersen J, et al. Sentinel node biopsy in cutaneous melanoma. Scand J Plast Reconstr Surg Hand Surg. 2006;40(1):24–31.CrossRefPubMed
61.
Ranieri JM, et al. The prognostic importance of sentinel lymph node biopsy in thin melanoma. Ann Surg Oncol. 2006;13(7):927–32.CrossRefPubMed
62.
Vaquerano J, et al. American Joint Committee on Cancer clinical stage as a selection criterion for sentinel lymph node biopsy in thin melanoma. Ann Surg Oncol. 2006;13(2):198–204.CrossRefPubMed
63.
Wong SL, et al. Results of sentinel lymph node biopsy in patients with thin melanoma. Ann Surg Oncol. 2006;13(3):302–9.CrossRefPubMed
64.
Cecchi R, et al. Sentinel lymph node biopsy in patients with thin melanomas. J Dermatol. 2007;34(8):512–5.CrossRefPubMed
65.
Koskivuo I, et al. Sentinel lymph node biopsy in cutaneous melanoma: a case-control study. Ann Surg Oncol. 2007;14(12):3566–74.CrossRefPubMed
66.
Starz H, Balda BR. Benefit of sentinel lymphadenectomy for patients with nonulcerated cutaneous melanomas in the Breslow range between 0.76 and 1 mm: a follow-up study of 148 patients. Int J Cancer. 2007;121(3):689–93.CrossRefPubMed
67.
Mattsson J, et al. Sentinel node biopsy in malignant melanoma: Swedish experiences 1997–2005. Acta Oncol. 2008;47(8):1519–25.CrossRefPubMed
68.
Roulin D, et al. Prognostic value of sentinel node biopsy in 327 prospective melanoma patients from a single institution. Eur J Surg Oncol. 2008;34(6):673–9.CrossRefPubMed
69.
Wright BE, et al. Importance of sentinel lymph node biopsy in patients with thin melanoma. Arch Surg. 2008;143(9):892–9 (Discussion 899–900).
70.
Aviles-Izquierdo JA, Lazaro-Ochaita P. Sentinel node biopsy as a prognostic factor in cutaneous melanoma. Actas Dermo-Sifiliogr. 2009;100(6):486–92.CrossRefPubMed
71.
Testori A, et al. Clinical considerations on sentinel node biopsy in melanoma from an Italian multicentric study on 1313 patients (SOLISM-IMI). Ann Surg Oncol. 2009;16(7):2018–27.CrossRefPubMed
72.
Ellis MC, et al. Sentinel lymph node staging of cutaneous melanoma: predictors and outcomes. Am J Surg. 2010;199(5):663–8.CrossRefPubMed
73.
Kunte C, et al. Prognostic factors associated with sentinel lymph node positivity and effect of sentinel status on survival: an analysis of 1049 patients with cutaneous melanoma. Melanoma Res. 2010;20(4):330–7.CrossRefPubMed
74.
Socrier Y, et al. Histological regression in primary melanoma: not a predictor of sentinel lymph node metastasis in a cohort of 397 patients. Br J Dermatol. 2010;162(4):830–4.CrossRefPubMed
75.
Vermeeren L, et al. Sentinel lymph node biopsy in patients with thin melanoma: occurrence of nodal metastases and its prognostic value. Eur J Dermatol. 2010;20(1):30–34.PubMed
76.
Andtbacka RH, et al. Sentinel lymph node biopsy for melanoma in pregnant women. Ann Surg Oncol. 2013;20(2):689–96.CrossRefPubMed
77.
Rughani MG, et al. Sentinel lymph node biopsy in melanoma: the Oxford ten year clinical experience. J Plast Reconstr Aesth Surg. 2011;64(10):1284–90.CrossRef
78.
79.
Hinz T, et al. Prognostic value of sentinel lymph node biopsy in 121 low-risk melanomas (tumour thickness <1.00 mm) on the basis of a long-term follow-up. Eur J Nucl Med Mol Imaging. 2012;39(4):581–8.CrossRefPubMed
80.
Chu VH, et al. Impact of the 2009 (7th Edition) AJCC melanoma staging system in the classification of thin cutaneous melanomas. BioMed Res Int. 2013;2013:898719.
81.
Cooper C, et al. A 10-year, single-institution analysis of clinicopathologic features and sentinel lymph node biopsy in thin melanomas. J Am Acad Dermatol. 2013;69(5):693–9.CrossRefPubMed
82.
Egger ME, et al. Outcomes and prognostic factors in superficial spreading melanoma. Am J Surg. 2013;206(6):861–8.CrossRefPubMed
83.
Mori M, et al. Clinicopathologic analysis of 66 Japanese thin melanomas with metastasis of sentinel or regional lymph node. J Cutan Pathol. 2013;40(12):1027–34.CrossRefPubMed
84.
Mozzillo N, et al. Sentinel node biopsy in thin and thick melanoma. Ann Surg Oncol. 2013;20(8):2780–6.CrossRefPubMed
85.
van den Broek FJ, et al. Sentinel lymph node biopsy for cutaneous melanoma: results of 10 years’ experience in two regional training hospitals in the Netherlands. Int J Clin Oncol. 2013;18(3):428–34.CrossRefPubMed
86.
Botella-Estrada R, et al. Correlation of histologic regression in primary melanoma with sentinel node status. JAMA Dermatol. 2014;150(8):828–35.CrossRefPubMed
87.
Voit, C.A., et al., Ultrasound-guided fine needle aspiration cytology as an addendum to sentinel lymph node biopsy can perfect the staging strategy in melanoma patients. Eur J Cancer (Oxford, England: 1990). 2014;50(13):2280–8.
Metadaten
Titel
Sentinel Lymph Node Biopsy in Thin Cutaneous Melanoma: A Systematic Review and Meta-Analysis
verfasst von
Erin Cordeiro, MD, MSc, FRCSC
Mai-Kim Gervais, MD, FRCSC
Prakesh S. Shah, MD, MSc, FRCPC
Nicole J. Look Hong, MD, MSc, FRCSC
Frances C. Wright, MD, MEd, FRCSC
Publikationsdatum
01.03.2016
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 13/2016
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5137-z

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