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(Reference retrieved automatically from SciELO through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Vertical growth phase and positive sentinel node in thin melanoma

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Author(s):
R.S. Oliveira Filho [1] ; L.M. Ferreira [2] ; L.J. Biasi [3] ; M.M.S.S. Enokihara [4] ; G.R. Paiva [5] ; J. Wagner [6]
Total Authors: 6
Affiliation:
[1] Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Cirurgia
[2] Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Cirurgia
[3] Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Cirurgia
[4] Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Patologia - Brasil
[5] Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Cirurgia
[6] Hospital Israelita Albert Einstein. Serviço de Medicina Nuclear - Brasil
Total Affiliations: 6
Document type: Journal article
Source: Brazilian Journal of Medical and Biological Research; v. 36, n. 3, p. 347-350, 2003-03-00.
Abstract

Sentinel node (SN) status is the most important prognostic factor for localized melanoma. Usually, patients with Breslow thickness of less than 1.0 mm are not included in SN protocols. However, the literature presents a rate ranging from 3 to 7% of nodal recurrence in thin melanoma. Ulceration, regression and high mitotic rate have been considered to be indications for an SN biopsy. The metastatic potential of the vertical growth phase is uncertain. To correlate pathological features in thin melanoma with SN metastasis, we reviewed 358 patients submitted to SN biopsy. Seventy-seven patients with lesions of 1 mm or smaller were included in the study group. Histological evaluation of the primary tumor included thickness, Clark level, mitotic rate, ulceration, regression, and growth phase. Lymphoscintigraphy was performed on all patients. Lymphatic mapping and gamma probe detection were both used for SN biopsy. Histological examination of SN consisted of hematoxylin-eosin and immunohistochemical staining. Median follow-up was 37 months. Six patients had micrometastases. Statistical analysis by the Fisher test showed that ulceration (P = 0.019), high mitotic rate (P = 0.008) and vertical growth phase (P = 0.002) were positively correlated with micrometastases. If other studies confirm these results, more melanoma patients must be submitted to SN biopsy. (AU)