Multiple Lymph Node Basin Drainage in Trunk Melanoma Is Not Associated with Survival of Sentinel Lymph Node-Positive Patients

Simone Ribero, Simona Osella Abate, Sadro Pasquali, Carlo Riccardo Rossi, Lorenzo Borgognoni, Dario Piazzalunga, Nicola Solari, Mauro Schiavon, Paola Brandani, Luca Ansaloni, Erica Ponte, Francesco Silan, Antonio Sommariva, Francesco Bellucci, Giuseppe Macripò, Pietro Quaglino, Italian Melanoma Intergroup (IMI), Paola Queirolo

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: This study was aimed at investigating the prognostic role of multiple lymph node basin drainage (MLBD) in patients with positive sentinel lymph node (SLN) biopsy. Background: MLBD is frequently observed in patients with trunk melanoma undergoing SLN. The prognostic value of MLBD in SLN-positive patients is still debated. Methods: Retrospective data from 312 trunk melanoma patients with positive SLN biopsy (1991-2012) at 6 Italian referral centres were gathered in a multicentre database. MLBD was defined at preoperative lymphoscintigraphy. Clinical and pathological data were analysed for their association with disease-free interval (DFI) and disease-specific (DSS) survival. Results: MLBD was identified in 34.6% of patients (108/312) and was significantly associated with >1 positive SLN (37 vs. 15.2%; p <0.001) and with >1 positive lymph node (LN) after complete lymph node dissection (CLND) (50.9 vs. 34.8%; p = 0.033). No differences were observed according to drainage pattern in patients who had negative and positive non-SLN at CLND. MLBD was not associated with either DFI or DSS. Multivariate analyses showed that tumour thickness, ulceration, and number of metastatic LNs were associated with worse DFI and DSS, while regression confirmed its protective role in survival. Conclusion: In positive SLN patients, MLBD has no association with survival, which is mainly related to American Joint Committee on Cancer (AJCC) prognostic factors. Since the overall number of positive LNs drives the prognosis, the importance of a CLND in all the positive basins is confirmed.
Original languageEnglish
Pages (from-to)205-211
Number of pages7
JournalDermatology
Volume233
Issue number2-3
DOIs
Publication statusPublished - Oct 1 2017

Keywords

  • Melanoma
  • Sentinel lymph node
  • Surgery in dermatological practice
  • Survival

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