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World Journal of Surgery

Published in:

01-03-2012

Multiple Lymphatic Basin Drainage from Cutaneous Melanoma as a Prognostic Factor

Authors: Antonio Piñero, Carlos de Torre, Jorge Martínez-Escribano, Juana Campillo, Manuel Canteras, Francisco Nicolás

Published in: World Journal of Surgery | Issue 3/2012

Abstract

Background

There is some controversy in the literature regarding the possible prognostic value of cases of multiple lymphatic basin drainage (MLBD). The purpose of this work was to study the differences in prognosis depending on whether there is MLBD from primary cutaneous melanoma.

Methods

We conducted a cohort analysis from a prospective database, and 112 consecutive patients with cutaneous melanoma were included. Sentinel lymph node biopsy (SLNB) was done in all of them. MLBD was defined as the occurrence of two or more different nodal basins from the same lesion. The demographic and clinical data for cases with a single nodal drainage basin and MLBD were statistically compared using Fisher’s exact test, the χ² test, or Mann–Whitney’s test according to the type of variables studied. Multivariate analysis also was performed on the disease-free survival rate using logistic regression analysis. The distribution of disease-free survival was determined using a Cox proportional risk model.

Results

Only gender (27% men and 8% women; P = 0.01) and the localization of the primary tumor in the trunk (P < 0.001) were associated with the presence of MLBD. It also was observed that the cases with a high Breslow thickness or with MLBD were only associated with a worse disease-free survival rate in cases with positive (P < 0.01 and P = 0.047, respectively) and negative (P < 0.011 and P = 0.019, respectively) SLNB.

Conclusions

This study suggests that both Breslow thickness and the presence of MLBD are statistically significant independent prognostic factors of disease-free survival in patients with cutaneous melanoma.

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Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (eds) (2010) Melanoma of the skin. In: AJCC cancer staging manual, 7th edn. New York, Springer-Verlag, pp 325–344

Berk DR, Jonson DL, Uzieblo A et al (2005) Sentinel lymph node biopsy for cutaneous melanoma: the Stanford experience, 1997–2004. Arch Dermatol 141:1016–1023PubMedCrossRef

Mandalá M, Invertí GL, Piazzalunga D et al (2009) Clinical and histopathological risk factors to predict sentinel lymph node positivity, disease-free and overall survival in clinical stages I-II AJCC skin melanoma: outcome analysis from a single-institution prospectively collected database. Eur J Cancer 45:2537–2545PubMedCrossRef

Balch CM, Soong S, Ross MI et al (2000) Long-term results of a multi-institutional randomized trial comparing prognostic factors and surgical results for intermediate thickness melanomas (1.0 to 4.0 mm). Ann Surg Oncol 7:87–97PubMedCrossRef

Cormier JN, Xing Y, Ding M et al (2005) Population-based assessment of surgical treatment trends for patients with melanoma in the era of sentinel lymph node biopsy. J Clin Oncol 23:6054–6062PubMedCrossRef

Porter GA, Ross MI, Berman RS et al (2000) Significance of multiple nodal basin drainage in truncal melanoma patients undergoing sentinel lymph node biopsy. Ann Surg Oncol 7:256–261PubMedCrossRef

Jimenez RE, Panageas K, Busam KJ et al (2005) Prognostic implications of multiple lymphatic basin drainage in patients with truncal melanoma. J Clin Oncol 23:518–524PubMedCrossRef

McHugh JB, Su L, Griffith KA et al (2006) Significance of multiple lymphatic basin drainage in truncal melanoma patients undergoing sentinel lymph node biopsy. Ann Surg Oncol 13:1216–1223PubMedCrossRef

Martel P, Garrido I, Ferron G et al (2010) An individualized prognosis for truncal melanoma ? A series of 77 cases. Bull Cancer 97:901–907PubMed

10.

Piñero A, Martínez-Escribano J, Nicolás F et al (2001) Selective sentinel node biopsy in melanoma using preoperative lymphoscintigraphy location and intraoperative detection gamma probe. Med Clin (Barc) 117:481–486

11.

Morton DL, Thompson JF, Cochran AJ et al (2006) Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 355:1307–1317PubMedCrossRef

12.

Leong SP, Morita ET, Sudmeyer M et al (2005) Heterogeneous patterns of lymphatic drainage to sentinel lymph nodes by primary melanoma from different anatomic sites. Clin Nucl Med 30:150–158PubMedCrossRef

13.

Dale PS, Foshag LJ, Wanek LA et al (1997) Metastasis of primary melanoma to two separate lymph node basins: prognostic significance. Ann Surg Oncol 4:13–18PubMedCrossRef

14.

Wall JK, Florero M, Accortt NA et al (2007) Impact of multiple lymphatic channel drainage to a single nodal basin on outcomes in melanoma. Arch Surg 142:753–758PubMedCrossRef

15.

Vuylsteke RJ, van Leeuwen PA, Statius Muller MG et al (2003) Clinical outcome of stage I/II melanoma patients after selective sentinel lymph node dissection: long-term follow-up results. J Clin Oncol 21(6):1057–1065PubMedCrossRef

16.

Zogakis TG, Essner R, Wang HJ et al (2005) Melanoma recurrence patterns after negative sentinel lymphadenectomy. Arch Surg 140(9):865–871PubMedCrossRef

17.

Koskivuo I, Talve L, Vihinen P et al (2007) Sentinel lymph node biopsy in cutaneous melanoma: a case-control study. Ann Surg Oncol 14(12):3566–3574PubMedCrossRef

18.

Federico AC, Chapgar AB, Ross MI et al (2008) Effect of multiple-nodal basin drainage on cutaneous melanoma. Arch Surg 143:632–638PubMedCrossRef

Title: Multiple Lymphatic Basin Drainage from Cutaneous Melanoma as a Prognostic Factor
Authors: Antonio Piñero
Carlos de Torre
Jorge Martínez-Escribano
Juana Campillo
Manuel Canteras
Francisco Nicolás
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 3/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1402-2

ACC 2024 Congress

Springer Medicine

Multiple Lymphatic Basin Drainage from Cutaneous Melanoma as a Prognostic Factor

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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