Vertical growth phase and positive sentinel node in thin melanoma

Vertical growth phase and positive sentinel node in thin melanoma

Author Oliveira Filho, Renato Santos de Autor UNIFESP Google Scholar
Ferreira, Lydia Masako Autor UNIFESP Google Scholar
Biasi, Luciano Jose Autor UNIFESP Google Scholar
Enokihara, Mílvia Maria Simões e Silva Autor UNIFESP Google Scholar
Paiva, Geruza Rezende Autor UNIFESP Google Scholar
Wagner, Jairo Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Hospital Israelita Albert Einstein Serviço de Medicina Nuclear
Abstract Sentinel node (SN) status is the most important prognostic factor for localized melanoma. Usually, patients with Breslow thickness of less than 1.0 mm are not included in SN protocols. However, the literature presents a rate ranging from 3 to 7% of nodal recurrence in thin melanoma. Ulceration, regression and high mitotic rate have been considered to be indications for an SN biopsy. The metastatic potential of the vertical growth phase is uncertain. To correlate pathological features in thin melanoma with SN metastasis, we reviewed 358 patients submitted to SN biopsy. Seventy-seven patients with lesions of 1 mm or smaller were included in the study group. Histological evaluation of the primary tumor included thickness, Clark level, mitotic rate, ulceration, regression, and growth phase. Lymphoscintigraphy was performed on all patients. Lymphatic mapping and gamma probe detection were both used for SN biopsy. Histological examination of SN consisted of hematoxylin-eosin and immunohistochemical staining. Median follow-up was 37 months. Six patients had micrometastases. Statistical analysis by the Fisher test showed that ulceration (P = 0.019), high mitotic rate (P = 0.008) and vertical growth phase (P = 0.002) were positively correlated with micrometastases. If other studies confirm these results, more melanoma patients must be submitted to SN biopsy.
Keywords Thin melanoma
Sentinel node
Lymphoscintigraphy
Immunohistochemistry
Micrometastasis
Language English
Date 2003-03-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 36, n. 3, p. 347-350, 2003.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 347-350
Origin http://dx.doi.org/10.1590/S0100-879X2003000300009
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000181920300009
SciELO ID S0100-879X2003000300009 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/1669

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