Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 10:50:e20233521.
doi: 10.1590/0100-6991e-20233521-en. eCollection 2023.

Evaluation of tumor load in sentinel lymph node in patients with cutaneous melanoma

[Article in English, Portuguese]
Pedro Deak DE Almeida  1 , Luccas Lavareze  2 , Carolina Emerick DA Silva Rangel  2 , Fernanda Viviane Mariano  2 , Diego Victor Nunes Rodrigues  3 , Tiago Antonio Baldasso  1 , Renato Ventura Fanni  1 , Andre Luis Maion Casarim  1 , André Del Negro  1 , Alfio José Tincani  1
Affiliations

Evaluation of tumor load in sentinel lymph node in patients with cutaneous melanoma

[Article in English, Portuguese]
Pedro Deak DE Almeida et al. Rev Col Bras Cir. .

Abstract
in English, Portuguese

Introduction: cutaneous melanoma (MC) is a malignant neoplasm derived from melanocytic cells with an aggressive behavior. It is usually associated with the multifactorial interaction of genetic susceptibility and environmental exposure, usually ultraviolet radiation. Despite advances in treatment, the disease remains relentless with poor prognosis. Sentinel lymph node (SLN) biopsy is a technique used to screen patients in need of lymph node dissection.

Objectives: to correlate the tumor burden in the SLN with the mortality of patients undergoing SLN biopsy.

Methodology: the medical records and histological slides of patients with MC who underwent SLN biopsy treated at HC-Unicamp from 2001 to 2021 were retrospectively analyzed. The positive SLN were measured according to the size of the tumor infiltration area, for analysis of the depth of invasion (DI), closest proximity to the capsule (CPC) and tumor burden (TB). For statistical analysis, associations between variables were analyzed using Fishers exact test, with post Bonferroni test and Wilcoxon test.

Results: 105 records of patients who underwent SLN biopsy of MC were identified. Of these, nine (8.6%) had positive SLN and 81 (77.1%) had negative SLN. The performed lymphadenectomies resulted in 55.6% (n=5) affected, 22.2% (n=2) without disease and 22.2% (n=2) were not performed. Mean CPC, TB, and DI were 0.14mm, 32.10mm and 2.33mm, respectively. Patients with T2 and T3 tumors were more likely to show the SLN affected (p=0.022). No patient with positive SLN died during follow-up.

Conclusion: patients who presented T3 staging are the ones who most presented positive SLN.

Introdução:: o melanoma cutâneo (MC) é uma neoplasia maligna de comportamento agressivo, derivada das células melanocíticas, geralmente causado pela associação de interação da suscetibilidade genética e a exposição ambiental. A biópsia do linfonodo sentinela (LNS) é um procedimento utilizado para rastreamento de doentes com necessidade ou não de linfadenectomia, diminuindo a exposição do paciente a cirurgias maiores.

Objetivos:: correlacionar a carga do tumor no LNS com a mortalidade de pacientes com MC.

Métodos:: foram examinados retrospectivamente prontuários e lâminas histológicas de doentes com MC submetidos a biópsia de LNS atendidos no HC-Unicamp entre o período compreendido de 2001 a 2021. Os LNS positivos foram mensurados quanto ao tamanho da área de infiltração do tumor, para análise da profundidade de invasão (PI), menor proximidade com a cápsula (MPC) e carga do tumor (CT). As associações entre as variáveis foram analisadas pelo teste Exato de Fisher, com pós teste de Bonferroni e Wilcoxon.

Resultados:: foram identificados 105 pacientes com biópsia de LNS, sendo nove (8,6%) casos com LNS positivo. A média de MDC, CT e PI foram 0,14 mm, 32,10 mm, e 2,33 mm, respectivamente. Doentes com tumores T2 e T3 apresentaram maior chance de acometimento do LNS (p=0,022). Nenhum paciente com LNS positivo foi a óbito durante o acompanhamento.

Conclusão:: doentes que apresentaram tumores maiores (T2 e T3) apresentaram maior chance de linfonodos sentinelas positivos. Além do tamanho do tumor, a presença de maior carga do tumor demonstrou que os mesmos podem ser beneficiados pela biópsia de LNS.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: no.

Figures

Figure 1
Figure 1. DI, CPC, and TB measurement methodology.
Figure 2
Figure 2. A) SLN almost entirely involved by cutaneous melanoma metastasis. Metastasis can occur in scattered cells (B) or in a small nest of cells in close contact with the capsule (C). Metastases from amelanotic melanoma (D and E) forming nests of malignant cells in the SLN parenchyma.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Ahmed B, Qadir MI, Ghafoor S. Malignant Melanoma Skin CancerDiagnosis, Prevention, and Treatment. Crit Rev Eukaryot Gene Expr. 2020;30(4):291–297. doi: 10.1615/CritRevEukaryotGeneExpr.2020028454. - DOI - PubMed
    1. Elwood JM, Jopson J. Melanoma and sun exposure An overview of published studies. Int J Cancer. 1997;73(2):198–203. doi: 10.1002/(sici)1097-0215(19971009)73:2<198::aid-ijc6>3.0.co;2-r. - DOI - PubMed
    1. Lodde G, Zimmer L, Livingstone E. Malignes Melanom. Pathologe. 2020;41(3):281–292. doi: 10.1007/s00292-020-00776-x. - DOI - PubMed
    1. Hayes AJ, Maynard L, Coombes G. Wide versus narrow excision margins for high-risk, primary cutaneous melanomas long-term follow-up of survival in a randomized trial. Lancet Oncol. 2016;17(2):184–192. doi: 10.1016/S1470-2045(15)00482-9. - DOI - PMC - PubMed
    1. Nader MG, Munhoz RR, Teixeira MLP. Trends in Melanoma Mortality in Brazil A Registry-Based Study. JCO Glob Oncol. 2020;6:1766–1771. doi: 10.1200/GO.20.00426. - DOI - PMC - PubMed