In transit sentinel node drainage as a prognostic factor for patients with cutaneous melanoma

J Surg Oncol. 2018 Apr;117(5):864-867. doi: 10.1002/jso.25023. Epub 2018 Feb 26.

Abstract

Background: Minor basin or in transit node drainage can be found in patients with cutaneous melanoma who undergo sentinel node biopsy. Its clinical impact is still unclear. Our objective is to evaluate clinical outcomes in patients who presented with in transit sentinel node (ITN) drainage.

Material and methods: Retrospective analysis of patients who underwent sentinel node biopsy (SNB) in a single Brazilian institution between 2000 and 2015.

Results: Our cohort comprised 1223 SNB. There were 64 patients (5.2%) with ITN. Melanoma of the limbs (OR 10.61, P < 0.0001) and acral subtype (OR 3.49, P < 0.0001) were associated with ITN drainage. Among these 64 patients, 14 (21.9%) had a positive SNB. The ITN was positive for metastases in five patients, four in a popliteal basin and one on the trunk. Regarding completion node dissection (CND), two patients had positive non-sentinel nodes (NSN), both in major basins. In patients who developed recurrence, time to recurrence was shorter (mean time 18 vs 31.4 months, P = 0.001) and time to death was shorter (mean time 31.6 vs 40 months, P = 0.039) in those who had ITN drainage.

Conclusion: ITN drainage was associated with earlier recurrences and deaths from melanoma.

Keywords: in transit sentinel node; melanoma; sentinel lymph node.

MeSH terms

  • Drainage*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Melanoma / pathology*
  • Melanoma / surgery
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / surgery
  • Prognosis
  • Retrospective Studies
  • Sentinel Lymph Node / pathology*
  • Sentinel Lymph Node / surgery
  • Sentinel Lymph Node Biopsy*
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery
  • Survival Rate