In a nutshell
The authors aimed to analyze the risk factors for spread of thin melanoma to nearby lymph nodes. They found that tumor thickness of 0.75 mm or greater and rapid growth of cancer cells could be among the probable factors.
Some background
In skin melanoma, sentinel lymph nodes (SLN) are the first lymph nodes (tiny, bean-shaped organs that help fight infection) to which cancer cells are believed to spread (metastasis). The presence of SLN metastasis is determined by a procedure called sentinel lymph node biopsy (SLNB). It involves removing all or part of those nodes to determine whether the cancer has spread. SLNB is usually recommended for melanomas with a thickness of greater than 1 mm. For patients with tumor thickness less than 1 mm, it is not known with certainty which patients should undergo SLNB.
It will be beneficial to determine the risk factors in thin melanoma patients that could later lead to spread of cancer to the SLN.
Methods & findings
The authors aimed to determine the risk factors for spread of thin melanoma.
Data from 60 studies involving 10,928 patients were included in this analysis. All patients had tumor thickness of 1 mm or less and had undergone SLNB.
Overall, 4.5% of these patients had spread of melanoma to the SLN. Patients having melanoma thickness of 0.75 mm or greater were at high-risk of having positive SLN (tumors in SLN), with an 8.8% likelihood of SLN metastasis. Patients with tumors deeper in the skin layers had a 7.3% chance of spread of cancer to the SLN. In patients who had small clusters of tumor cells apart from the main tumor (microsatellites), the likelihood of cancer spread to the SLN was 26.6%.
The bottom line
The authors concluded that melanoma thickness of 0.75 mm or greater, depth of the tumor, and presence of microsatellites were some of the important factors for cancer spread to SLN.
What’s next?
Discuss your risk of sentinal lymph node metastasis with your doctor.
Published By :
Annals of Surgical Oncology
Date :
Mar 01, 2016
