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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

01-05-2016 | Melanomas

Prognostic Role of Multiple Lymphatic Basin Drainage in Sentinel Lymph Node-Negative Trunk Melanoma Patients: A Multicenter Study from the Italian Melanoma Intergroup

Authors: Simone Ribero, MD, PhD, Simona Osella-Abate, ScD, Sandro Pasquali, MD, Carlo Riccardo Rossi, Lorenzo Borgognoni, MD, Dario Piazzalunga, MD, Nicola Solari, MD, Mauro Schiavon, MD, Paola Brandani, MD, Luca Ansaloni, MD, Erica Ponte, MD, Francesco Silan, MD, Antonio Sommariva, MD, Francesco Bellucci, MD, Giuseppe Macripò, MD, Pietro Quaglino, MD

Published in: Annals of Surgical Oncology | Issue 5/2016

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Abstract

Background

Multiple lymphatic basin drainage (MLBD) is frequently observed in patients with trunk melanoma undergoing sentinel lymph node (SLN) biopsy. Conflicting data regarding the prognostic association of MLBD in SLN-negative patients have been reported. This study aimed to investigate the prognostic role of MLBD in patients with negative SLN biopsy.

Methods

Retrospective data from 656 melanoma patients who underwent a SLN biopsy (1991–2012) at six Italian centers were gathered in a multicenter database. MLBD was defined as lymphoscintigraphic and intraoperative identification of an SLN in more than one nodal basin. Clinical and pathologic variables were recorded and analyzed for their impact on survival.

Results

SLN-negative patients with MLBD were at lower risk of melanoma recurrence [hazard ratio (HR) 0.73, P = 0.05) and melanoma-related death (HR 0.68, P = 0.001) independent of common staging features. Multivariable Cox analyses of disease-free interval (DFI) and disease-specific survival (DSS) showed that MLBD maintained a favorable role and ulceration an unfavorable role. Histologic regression was independently associated only with DFI. When survival was stratified according to presence of MLBD, histologic regression and Breslow thickness <2 mm were associated with improved DFI (5-year DFI: 96.9 vs. 66,1 %, respectively; HR 0.48, P < 0.001) and DSS (5-year DSS: 96.7 vs. 71.8 %, respectively; HR 0.52, P = 0.005) compared to patients without these three favorable parameters.

Conclusions

Patients with negative SLN biopsy results have better prognosis when two or more lymphatic basins are identified and analyzed. Further research is required to investigate the mechanisms behind this evidence.
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Metadata
Title
Prognostic Role of Multiple Lymphatic Basin Drainage in Sentinel Lymph Node-Negative Trunk Melanoma Patients: A Multicenter Study from the Italian Melanoma Intergroup
Authors
Simone Ribero, MD, PhD
Simona Osella-Abate, ScD
Sandro Pasquali, MD
Carlo Riccardo Rossi
Lorenzo Borgognoni, MD
Dario Piazzalunga, MD
Nicola Solari, MD
Mauro Schiavon, MD
Paola Brandani, MD
Luca Ansaloni, MD
Erica Ponte, MD
Francesco Silan, MD
Antonio Sommariva, MD
Francesco Bellucci, MD
Giuseppe Macripò, MD
Pietro Quaglino, MD
Publication date
01-05-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4973-6

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