Authors: R. Kraft Rovere; V. D. de Almeida; C. H. de Freitas; P. Costa Câmara; R. Danesi Pinto Authors‘ workplace: Department of Medicine, Regional University of Blumenau, Brazil Published in: Klin Onkol 2025; 38(6): 472-478 Category: Original Articles doi: https://doi.org/10.48095/ccko2025472
Background: This study aims to evaluate the relationship between sentinel lymph node positivity and risk factors associated with cutaneous melanoma, as well as the epidemiological data of patients diagnosed with this condition in the Blumenau-SC region. Material and methods: This is a cross-sectional study analyzing medical records of patients diagnosed with melanoma who underwent sentinel lymph node biopsy at a nuclear medicine service in Blumenau, Santa Catarina. The variables analyzed included Breslow classification, Clark classification, regression, ulceration, histological subtype, age, and sex. Patients were divided into two groups: those with a positive diagnosis and those with a negative diagnosis. Results: The variables with the highest statistical significance were: histological subtype, with nodular melanomas associated with positivity (P < 0.001); ulceration, which was more prevalent in the positive group (P = 0.0018); Breslow classification, which showed a significantly higher mean in the positive group (P = 0.0002, Mann-Whitney test); and Clark level, which was significant in patients with higher classifications. Other variables analyzed did not show statistical significance. Study limitations: The mitotic index was not analyzed as a variable; this study was based on the 7th edition of the American Joint Committee on Cancer (AJCC) cancer staging manual. Conclusion: This study presented results consistent with current literature, confirming the predictive values of sentinel lymph node positivity, aiding in better patient selection for this invasive procedure, and avoiding unnecessary analyses that may lead to irreversible adverse effects.
1. INCA. National cancer institute 2017. [online]. Available from: http: //www.inca.gov.br/estimativa/2016/tabelaestados.asp?UF=BR.
2. Naser N. Cutaneous melanoma: 30-year epidemiological study in a city in southern Brazil, from 1980–2009. An Bras Dermatol 2011; 86 (5): 932–941.
3. Castro LGM, Messina MCL, Loureiro WR et al. Brazilian Dermatology Society guidelines for the diagnosis, treatment, and follow-up of primary cutaneous melanoma – part I. An Bras Dermatol 2015; 90 (6): 851–861. doi: 10.1590/abd1806-4841.20154707.
4. Morton D, Thompson J, Cochran A et al. Final trial report of sentinel-node biopsy versus nodal observation in melanoma. N Engl J Med 2014; 370 (7): 599–609. doi: 10.1056/NEJMoa1310460.
5. Venna S, Thummala S, Nosrati M et al. A predictive model to determine the likelihood of positive sentinel lymph node biopsy in thin melanomas. J Clin Oncol 2010; 28 (Suppl 15): 8549.
6. Han D, Zager J, Shyr Y et al. Clinicopathologic predictors of sentinel lymph node metastasis in thin melanoma. J Clin Oncol 2013; 31 (35): 4387–4393. doi: 10.1200/JCO.2013.50.1114.
7. Cadili A, Dabbs K. Predictors of sentinel lymph node metastasis in melanoma. Can J Surg 2008; 53 (1): 32–36.
8. Cordeiro E, Gervais M, Shah P et al. Sentinel lymph node biopsy in thin cutaneous melanoma: a systematic review and meta-analysis. Ann Surg Oncol 2016; 23 (13): 4178–4188. doi: 10.1245/s10434-016-5137-z.
9. Rovere K, Silva de Lima A, DeMarchi V et al. Sentinel lymph node in melanoma – a study conducted in the south of Brazil. Klin Onkol 2016; 29 (4): 274–278.
10. Edge S. AJCC cancer staging manual. New York: Springer 2010.
11. McMasters K, Egger M, Edwards M et al. Final results of the sunbelt melanoma trial: a multi-institutional prospective randomized phase III study evaluating the role of adjuvant high-dose interferon alfa-2b and completion lymph node dissection for patients staged by sentinel lymph node biopsy. J Clin Oncol 2016; 34 (10): 1079–1086. doi: 10.1200/JCO.2015.63.3776.
12. Bartlett E, Gimotty P, Sinnamon A et al. Clark level risk stratifies patients with mitogenic thin melanomas for sentinel lymph node biopsy. Ann Surg Oncol 2013; 21 (2): 643–649. doi: 10.1245/s10434-013-3313-y.
13. Silva FB, Oliveira Filho RS, Iared W et al. Indications for sentinel lymph node biopsy in thin melanomas. Einstein (São Paulo) 2010; 8 (2): 235–240. doi: 10.1590/S1679-45082010RW1424.
14. Lages RB, Vieira SC, Abreu BAL et al. Sentinel lymph node in melanoma: initial experience of a northeastern Brazilian center. An Bras Dermatol 2011; 86 (2): 379–382. doi: 10.1590/s0365-05962011000200030.
15. Mitra A, Conway C, Walker C et al. Melanoma sentinel node biopsy and prediction models for relapse and overall survival. Br J Cancer 2010; 103 (8): 1229–1236. doi: 10.1038/sj.bjc.6605849.
16. Lee J, Essner R, Torisu-Itakura H et al. Factors predictive of tumor-positive nonsentinel lymph nodes after tumor-positive sentinel lymph node dissection for melanoma. J Clin Oncol 2004; 22 (18): 3677–3684. doi: 10.1200/JCO.2004.01.012.
17. Kruper L, Spitz F, Czerniecki B et al. Predicting sentinel node status in AJCC stage I/II primary cutaneous melanoma. Cancer 2006; 107 (10): 2436–2445. doi: 10.1002/cncr.22295.
18. Warycha M, Zakrzewski J, Ni Q et al. Meta-analysis of sentinel lymph node positivity in thin melanoma (<or=1 mm). Cancer 2009; 115 (4): 869–879. doi: 10.1002/cncr.24044.
19. Wright B. Importance of sentinel lymph node biopsy in patients with thin melanoma. Arch Surg 2008; 143 (9): 892–899. doi: 10.1001/archsurg.143.9.892.
20. Paschoal F. Updates in Melanoma Staging. 2017 [online]. Available from: http: //gbm.org.br/wp-content/uploads/2017/04/BoletimGBM_marco2017_preview04.pdf.
Don‘t have an account? Create new account
Enter the email address that you registered with. We will send you instructions on how to set a new password.
