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Outcomes of Multiple Sentinel Lymph Node Basins Melanoma
Michael Subichin MD
Lawrence Cervino MD
Summa Health System
2020-02-14
Presenter: Michael Subichin MD
Affidavit:
I certify that this project represents the original work of Michael Subichin and has not to my knowledge been presented or published prior.
Director Name: Douglas Wagner MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction
For proper staging and management of melanoma, sentinel lymph node biopsy is an essential tool. A small subset of patients undergoing sentinel lymph node biopsy at the time of melanoma resection have multiple draining lymph node basins identified. The clinical implications of this remains unclear. We sought to determine outcomes and prognostic information for patients with multiple sentinel lymph node basins.
Patients and Methods
We performed a retrospective review of patients who underwent melanoma excision at a single center from 2013 to 2017. We identified 1330 patients who underwent melanoma excision, 501 patients who underwent sentinel lymph node biopsy from a single site and 18 patients who had sentinel nodes from multiple basins. We collected patient demographics, pathology characteristics, and recurrence outcomes. Student's t test and chi square were used for all analysis.
Results
All 18 patients with multiple sentinel node basins were included for analysis. Patients had follow up for an average of 30 months postoperatively. Patients with multiple lymph node basins were younger (52 vs 61 p<0.05) and more likely to have a positive node (22% VS 10%) than patients with a single nodal basin. There was no significant differences in recurrence rate (20% vs 16% p>0.05), gender, pathologic subtype, melanoma thickness, or follow up between groups.
Conclusion
Our experience demonstrates that patients with multiple sentinel lymph node basins melanoma are younger and more likely to have a positive node. Overall, this may represent a negative prognostic factor in melanoma outcomes.
