Single-Institution Study Shows No Correlation of Primary Melanoma Regression With Sentinel Node Status
In a single-institution study reported in JAMA Dermatology, Botella-Estrada et al found that regression of primary melanomas is not associated with sentinel node status.
Study Details
The retrospective study involved patients with melanomas with Breslow thickness > 0.75 mm undergoing sentinel node biopsy between January 2003 and December 2010 at Instituto Valenciano de Oncología.
Of melanomas in 201 patients (median age, 55 years), regression occurred in 52 (26%) and positive sentinel nodes were found in 40 (20%). Sentinel nodes were negative vs positive in 25% vs 2.5% of patients with Breslow thickness of ≤ 1.00 mm, 42% vs 20% of those with thickness of 1.01 to 2.00 mm, 19% vs 37.5% of those with thickness of 2.01 to 4.00 mm, and 14% vs 40% of those with thickness of > 4.00 mm (P < .001).
No Significant Correlation
There was no significant association of regression with node status, with regression being observed in 28% of patients with positive nodes vs 18% of those with negative nodes and no regression being observed in 72% vs 82% (P = .17). Patients with regression had a lower frequency of positive sentinel nodes in the ≤ 1.00-, 1.01- to 2.00-, and > 4.00-mm Breslow thickness groups, but the differences were not statistically significant.
Regression was more common with thin melanomas (≤ 1.00 mm; 33% vs no regression in 16%, P = .02), melanomas located on an axial site (75% vs no regression in 46%, P < .001), and superficial spreading or lentigo maligna melanoma types (69% vs no regression in 48%, P = .03).
The investigators concluded: “Regression of the primary melanoma is not associated with a higher proportion of positive [sentinel nodes]. These data do not support the practice of performing [sentinel node] biopsy in thin melanomas with regression in the absence of additional adverse prognostic characteristics.”
Rafael Botella-Estrada, MD, PhD, of Hospital Universitario La Fe, Valencia, is the corresponding author for the JAMA Dermatology article.
The authors reported no conflicts of interest.
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