Teixeira Vera, Vieira Ricardo, Coutinho Inês, Cabral Rita, Serra David, Julião Maria José, Brites Maria Manuel, Albuquerque Anabela, de Lima João Pedroso, Figueiredo Américo
Dermatology Department, Coimbra University Hospital, Praceta Mota Pinto, 3000-075 Coimbra, Portugal.
Dermatology Department, Coimbra University Hospital, Praceta Mota Pinto, 3000-075 Coimbra, Portugal ; Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
J Skin Cancer. 2013;2013:904701. doi: 10.1155/2013/904701. Epub 2013 Dec 25.
Background. Sentinel lymph node biopsy (SLNB) is a standard procedure for patients with localized cutaneous melanoma. The National Comprehensive Cancer Network (NCCN) Melanoma Panel has reinforced the status of the sentinel lymph node (SLN) as an important prognostic factor for melanoma survival. We sought to identify predictive factors associated with a positive SLNB and overall survival in our population. Methods. We performed a retrospective chart review of 221 patients who have done a successful SLNB for melanoma between 2004 and 2010 at our department. Univariate and multivariate analyses were done. Results. The SLNB was positive in 48 patients (21.7%). Univariate analysis showed that male gender, increasing Breslow thickness, tumor type, and absence of tumor-infiltrating lymphocytes were significantly associated with a positive SLNB. Multivariate analysis confirmed that Breslow thickness and the absence of tumor-infiltrating lymphocytes are independently predictive of SLN metastasis. The 5-year survival rates were 53.1% for SLN positive patients and 88.2% for SLN negative patients. Breslow thickness and the SLN status independently predict overall survival. Conclusions. The risk factors for a positive SLNB are consistent with those found in the previous literature. In addition, the SLN status is a major determinant of survival, which highlights its importance in melanoma management.
背景。前哨淋巴结活检（SLNB）是局限性皮肤黑色素瘤患者的标准程序。美国国立综合癌症网络（NCCN）黑色素瘤小组强化了前哨淋巴结（SLN）作为黑色素瘤生存重要预后因素的地位。我们试图确定在我们的人群中与SLNB阳性及总生存相关的预测因素。方法。我们对2004年至2010年期间在我们科室成功进行SLNB的221例黑色素瘤患者进行了回顾性病历审查。进行了单因素和多因素分析。结果。48例患者（21.7%）的SLNB为阳性。单因素分析显示，男性、Breslow厚度增加、肿瘤类型以及无肿瘤浸润淋巴细胞与SLNB阳性显著相关。多因素分析证实，Breslow厚度和无肿瘤浸润淋巴细胞是SLN转移的独立预测因素。SLN阳性患者的5年生存率为53.1%，SLN阴性患者为88.2%。Breslow厚度和SLN状态独立预测总生存。结论。SLNB阳性的危险因素与先前文献中发现的一致。此外，SLN状态是生存的主要决定因素，这突出了其在黑色素瘤管理中的重要性。
