Clinical and Dermoscopic Criteria Related to Melanoma Sentinel Lymph Node Positivity

• Published in: Anticancer research Vol. 27; no. 4C; pp. 2939 - 2944
• Main Authors: PAGNANELLI, Gianluca, BONO, Riccardo, PIZZICHETTA, Maria A, TALAMINI, Renato, ASCIERTO, Paolo A, TESTORI, Alessandro, STANGANELLI, Ignazio
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-07-2007
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Dermatology; Dermoscopy - methods; Female; Humans; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Medical sciences; Melanoma - pathology; Middle Aged; Retrospective Studies; Sentinel Lymph Node Biopsy - methods; Tumors; Tumors of the skin and soft tissue. Premalignant lesions; lymphatic mapping; Cartography; Lymphatic system; Cancerology; Sentinel lymph node; TNM staging system; Malignant melanoma; Melanoma; Lymphatic; Malignant tumor; TNM-System; dermoscopy
• ISSN: 0250-7005; 1791-7530

Background: The early detection of lymph node metastases may have important prognostic and therapeutic implications in melanoma
patients. The purpose of this study was to investigate whether specific clinical and/or dermoscopic features could be “in
vivo” predictors of sentinel lymph node (SLN) positivity in melanomas >1 mm thick. Materials and Methods: Five Italian centres
(Istituto Dermopatico dell'Immacolata, IDI, Rome; Skin Cancer Unit, Oncologia Dermatologica, CPO, Ravenna; Istituto Europeo
Oncologico, Milan; Centro di Riferimento Oncologico, Aviano; Istituto Nazionale Tumori, Naples) carried out a blind retrospective
study on 508 melanomas observed from January 1994 to December 2002. The clinical and dermoscopic features of 78 melanomas
>1 mm thick with the SLN biopsied were reviewed. Results: The tumour palpability was the only factor correlated to SLN positivity
in melanomas >1 mm thick. Palpability was found in 46.2% of nodal positive melanomas and in 18.5% of nodal negative melanomas
(p=0.03). The patients with palpable melanomas showed a higher risk of nodal metastasis (OR=3.8). Dermoscopy failed to recognize
predictive criteria for SLN positivity. Some clinical and dermoscopic features, although not statistically significant, showed
interesting differences between nodal-negative and nodal-positive melanomas. Conclusion: Melanoma palpability may suggest
the presence of nodal metastasis in >1 mm thick tumours.