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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2010

01-05-2010 | Melanomas

Validation Study of the S Classification for Melanoma Patients with Positive Sentinel Nodes: The Montreal Experience

Authors: Rami Younan, MD, A. Bougrine, MD, K. Watters, MD, A. Mahboubi, PhD, M. Bouchereau-Eyegue, MD, A. Loutfi, MD, F. Tremblay, MD, D. Bouffard, MD, A. Belisle, MD, G. Leblanc, MD, E. Nassif, MD, G. Martin, MD, E. Patocskai, MD, M. Alenezi, MD, S. Meterissian, MD

Published in: Annals of Surgical Oncology | Issue 5/2010

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Abstract

Background

Standard of care is to perform a complete lymph node dissection (CLND) in melanoma patients with positive sentinel lymph nodes (SLNs). However, less than 20% will have metastases in non-SLNs. The S classification was described to predict the non-SLN status, hoping to identify a subset of patients who can be spared the CLND. We tried to validate the feasibility and usefulness of this classification.

Materials and Methods

We performed a retrospective chart review. All melanoma cases between 1996 and 2006 were included, and 359 patients with SLN biopsies were identified. All pathology slides were reviewed with an emphasis on the S classification.

Results

There were 365 SLN biopsies performed. A total of 82 patients (22.8%) had positive SLNs, while 277 patients (77.2%) had negative SLNs. There were 22 patients classified as SI, 18 as SII, 37 as SIII, and 5 were unclassified. On CLND, only 10 patients (12.2%) had positive non-SLNs. None of these were classified as SI while 2 patients (11%) were classified as SII and 8 (22%) as SIII. The S category was found to be a predictor of non-SLN status, and this reached statistical significance (P = 0.044). On univariate analysis, only an increasing Breslow depth and ulceration were predictive of a non-SI status.

Conclusion

Our results suggest that the S classification is easily feasible and predicts the status of non-SLNs. No patient with SI status was found to have additional non-SLN positive nodes. A larger-scale, prospective trial should be done to confirm these results and possibly spare patients the morbidity of CLND with a positive SLN.
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Metadata
Title
Validation Study of the S Classification for Melanoma Patients with Positive Sentinel Nodes: The Montreal Experience
Authors
Rami Younan, MD
A. Bougrine, MD
K. Watters, MD
A. Mahboubi, PhD
M. Bouchereau-Eyegue, MD
A. Loutfi, MD
F. Tremblay, MD
D. Bouffard, MD
A. Belisle, MD
G. Leblanc, MD
E. Nassif, MD
G. Martin, MD
E. Patocskai, MD
M. Alenezi, MD
S. Meterissian, MD
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 5/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0876-8

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