Age as a predictor of sentinel node metastasis among patients with localized melanoma: An inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients

Charles M. Balch, John F. Thompson, Jeffrey E. Gershenwald, Seng Jaw Soong, Shouluan Ding, Kelly M. McMasters, Daniel G. Coit, Alexander M M Eggermont, Phyllis A. Gimotty, Timothy M. Johnson, John M. Kirkwood, Stanley P. Leong, Merrick I. Ross, David R. Byrd, Alistair J. Cochran, Martin C. Mihm, Donald L. Morton, Michael B. Atkins, Keith T. Flaherty, Vernon K. Sondak

Research output: Contribution to journalArticle

Abstract

Purpose. We have previously reported that older patients with clinical stage I and II primary cutaneous. Melanoma had lower survival rates compared to younger patients. We postulated that the incidence of nodal metastasis would therefore be higher among older melanoma patients. Methods. The expanded American Joint Committee on Cancer melanoma staging database contains a cohort of 7,756 melanoma patients who presented without clinical evidence of regional lymph node or distant metastasis and who underwent a sentinel node biopsy procedure as a component of their staging assessment. Results. Although older patients had primary melanoma features associated with more aggressive biology, we paradoxically observed a significant decrease in the incidence of sentinel node metastasis as patient age increased. Overall, the highest incidence of sentinel node metastasis was 25.8 % in patients under 20 years of age, compared to 15.5 % in patients 80 years and older (p <0.001). In contrast, 5-year mortality rates for clinical stage II patients ranged from a low of 20 % for those 20-40 years of age up to 38 % for those over 70 years of age. Patient age was an independent predictor of sentinel node metastasis in a multifactorial analysis (p <0.001). Conclusions. Patients with clinical stage I and II melanoma under 20 years of age had a higher incidence of sentinel lymph node metastasis but, paradoxically, a more favorable survival outcome compared to all other age groups. In contrast, patients >70 years had the most aggressive primary melanoma features and a higher mortality rate compared to all other age groups but a lower incidence of sentinel lymph node metastasis.

Original languageEnglish (US)
Pages (from-to)1075-1081
Number of pages7
JournalAnnals of Surgical Oncology
Volume21
Issue number4
DOIs
StatePublished - 2014
Externally publishedYes

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Melanoma
Neoplasm Metastasis
Mortality
Incidence
cyhalothrin
Neoplasm Staging
Survival Rate
Age Groups
Lymph Nodes
Databases
Biopsy
Skin

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Age as a predictor of sentinel node metastasis among patients with localized melanoma : An inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients. / Balch, Charles M.; Thompson, John F.; Gershenwald, Jeffrey E.; Soong, Seng Jaw; Ding, Shouluan; McMasters, Kelly M.; Coit, Daniel G.; Eggermont, Alexander M M; Gimotty, Phyllis A.; Johnson, Timothy M.; Kirkwood, John M.; Leong, Stanley P.; Ross, Merrick I.; Byrd, David R.; Cochran, Alistair J.; Mihm, Martin C.; Morton, Donald L.; Atkins, Michael B.; Flaherty, Keith T.; Sondak, Vernon K.

In: Annals of Surgical Oncology, Vol. 21, No. 4, 2014, p. 1075-1081.

Research output: Contribution to journalArticle

Balch, CM, Thompson, JF, Gershenwald, JE, Soong, SJ, Ding, S, McMasters, KM, Coit, DG, Eggermont, AMM, Gimotty, PA, Johnson, TM, Kirkwood, JM, Leong, SP, Ross, MI, Byrd, DR, Cochran, AJ, Mihm, MC, Morton, DL, Atkins, MB, Flaherty, KT & Sondak, VK 2014, 'Age as a predictor of sentinel node metastasis among patients with localized melanoma: An inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients', Annals of Surgical Oncology, vol. 21, no. 4, pp. 1075-1081. https://doi.org/10.1245/s10434-013-3464-x
Balch, Charles M. ; Thompson, John F. ; Gershenwald, Jeffrey E. ; Soong, Seng Jaw ; Ding, Shouluan ; McMasters, Kelly M. ; Coit, Daniel G. ; Eggermont, Alexander M M ; Gimotty, Phyllis A. ; Johnson, Timothy M. ; Kirkwood, John M. ; Leong, Stanley P. ; Ross, Merrick I. ; Byrd, David R. ; Cochran, Alistair J. ; Mihm, Martin C. ; Morton, Donald L. ; Atkins, Michael B. ; Flaherty, Keith T. ; Sondak, Vernon K. / Age as a predictor of sentinel node metastasis among patients with localized melanoma : An inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients. In: Annals of Surgical Oncology. 2014 ; Vol. 21, No. 4. pp. 1075-1081.
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title = "Age as a predictor of sentinel node metastasis among patients with localized melanoma: An inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients",
abstract = "Purpose. We have previously reported that older patients with clinical stage I and II primary cutaneous. Melanoma had lower survival rates compared to younger patients. We postulated that the incidence of nodal metastasis would therefore be higher among older melanoma patients. Methods. The expanded American Joint Committee on Cancer melanoma staging database contains a cohort of 7,756 melanoma patients who presented without clinical evidence of regional lymph node or distant metastasis and who underwent a sentinel node biopsy procedure as a component of their staging assessment. Results. Although older patients had primary melanoma features associated with more aggressive biology, we paradoxically observed a significant decrease in the incidence of sentinel node metastasis as patient age increased. Overall, the highest incidence of sentinel node metastasis was 25.8 {\%} in patients under 20 years of age, compared to 15.5 {\%} in patients 80 years and older (p <0.001). In contrast, 5-year mortality rates for clinical stage II patients ranged from a low of 20 {\%} for those 20-40 years of age up to 38 {\%} for those over 70 years of age. Patient age was an independent predictor of sentinel node metastasis in a multifactorial analysis (p <0.001). Conclusions. Patients with clinical stage I and II melanoma under 20 years of age had a higher incidence of sentinel lymph node metastasis but, paradoxically, a more favorable survival outcome compared to all other age groups. In contrast, patients >70 years had the most aggressive primary melanoma features and a higher mortality rate compared to all other age groups but a lower incidence of sentinel lymph node metastasis.",
author = "Balch, {Charles M.} and Thompson, {John F.} and Gershenwald, {Jeffrey E.} and Soong, {Seng Jaw} and Shouluan Ding and McMasters, {Kelly M.} and Coit, {Daniel G.} and Eggermont, {Alexander M M} and Gimotty, {Phyllis A.} and Johnson, {Timothy M.} and Kirkwood, {John M.} and Leong, {Stanley P.} and Ross, {Merrick I.} and Byrd, {David R.} and Cochran, {Alistair J.} and Mihm, {Martin C.} and Morton, {Donald L.} and Atkins, {Michael B.} and Flaherty, {Keith T.} and Sondak, {Vernon K.}",
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TY - JOUR

T1 - Age as a predictor of sentinel node metastasis among patients with localized melanoma

T2 - An inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients

AU - Balch, Charles M.

AU - Thompson, John F.

AU - Gershenwald, Jeffrey E.

AU - Soong, Seng Jaw

AU - Ding, Shouluan

AU - McMasters, Kelly M.

AU - Coit, Daniel G.

AU - Eggermont, Alexander M M

AU - Gimotty, Phyllis A.

AU - Johnson, Timothy M.

AU - Kirkwood, John M.

AU - Leong, Stanley P.

AU - Ross, Merrick I.

AU - Byrd, David R.

AU - Cochran, Alistair J.

AU - Mihm, Martin C.

AU - Morton, Donald L.

AU - Atkins, Michael B.

AU - Flaherty, Keith T.

AU - Sondak, Vernon K.

PY - 2014

Y1 - 2014

N2 - Purpose. We have previously reported that older patients with clinical stage I and II primary cutaneous. Melanoma had lower survival rates compared to younger patients. We postulated that the incidence of nodal metastasis would therefore be higher among older melanoma patients. Methods. The expanded American Joint Committee on Cancer melanoma staging database contains a cohort of 7,756 melanoma patients who presented without clinical evidence of regional lymph node or distant metastasis and who underwent a sentinel node biopsy procedure as a component of their staging assessment. Results. Although older patients had primary melanoma features associated with more aggressive biology, we paradoxically observed a significant decrease in the incidence of sentinel node metastasis as patient age increased. Overall, the highest incidence of sentinel node metastasis was 25.8 % in patients under 20 years of age, compared to 15.5 % in patients 80 years and older (p <0.001). In contrast, 5-year mortality rates for clinical stage II patients ranged from a low of 20 % for those 20-40 years of age up to 38 % for those over 70 years of age. Patient age was an independent predictor of sentinel node metastasis in a multifactorial analysis (p <0.001). Conclusions. Patients with clinical stage I and II melanoma under 20 years of age had a higher incidence of sentinel lymph node metastasis but, paradoxically, a more favorable survival outcome compared to all other age groups. In contrast, patients >70 years had the most aggressive primary melanoma features and a higher mortality rate compared to all other age groups but a lower incidence of sentinel lymph node metastasis.

AB - Purpose. We have previously reported that older patients with clinical stage I and II primary cutaneous. Melanoma had lower survival rates compared to younger patients. We postulated that the incidence of nodal metastasis would therefore be higher among older melanoma patients. Methods. The expanded American Joint Committee on Cancer melanoma staging database contains a cohort of 7,756 melanoma patients who presented without clinical evidence of regional lymph node or distant metastasis and who underwent a sentinel node biopsy procedure as a component of their staging assessment. Results. Although older patients had primary melanoma features associated with more aggressive biology, we paradoxically observed a significant decrease in the incidence of sentinel node metastasis as patient age increased. Overall, the highest incidence of sentinel node metastasis was 25.8 % in patients under 20 years of age, compared to 15.5 % in patients 80 years and older (p <0.001). In contrast, 5-year mortality rates for clinical stage II patients ranged from a low of 20 % for those 20-40 years of age up to 38 % for those over 70 years of age. Patient age was an independent predictor of sentinel node metastasis in a multifactorial analysis (p <0.001). Conclusions. Patients with clinical stage I and II melanoma under 20 years of age had a higher incidence of sentinel lymph node metastasis but, paradoxically, a more favorable survival outcome compared to all other age groups. In contrast, patients >70 years had the most aggressive primary melanoma features and a higher mortality rate compared to all other age groups but a lower incidence of sentinel lymph node metastasis.

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