TY - JOUR
T1 - Predictors and natural history of in-transit melanoma after sentinel lymphadenectomy
AU - Pawlik, Timothy M.
AU - Ross, Merrick I.
AU - Johnson, Marcella M.
AU - Schacherer, Christopher W.
AU - McClain, Dana M.
AU - Mansfield, Paul F.
AU - Lee, Jeffrey E.
AU - Cormier, Janice N.
AU - Gershenwald, Jeffrey E.
PY - 2005/8
Y1 - 2005/8
N2 - Background: In-transit recurrence is a unique and uncommon pattern of treatment failure in patients with melanoma. Little information exists concerning the incidence, predictors, and natural history of in-transit disease since the introduction of sentinel lymph node biopsy (SLNB). Methods: Between 1991 and 2001, 1395 patients with primary melanoma underwent SLNB. Univariate and multivariate logistic regression analyses were performed to examine the association among known clinicopathologic factors, in-transit recurrence, and distant metastatic failure after the development of in-transit disease. Results: With a median follow-up of 3.9 years, 241 patients (17.3%) experienced disease recurrence, including 91 (6.6%) who developed in-transit recurrence. Independent predictors of in-transit recurrence included age >50 years, a lower extremity location of the primary tumor, Breslow depth, ulceration, and sentinel lymph node (SLN) status. Of the 69 patients who presented with in-transit disease as the sole site of first recurrence, 39 developed distant disease. By univariate analysis, predictors of distant failure among patients with in-transit disease included SLN status, largest metastatic focus in the SLN >2.5 mm2, subcutaneous location of in-transit disease, in-transit tumor size ≥ 2 cm, and a disease-free interval before in-transit recurrence of
AB - Background: In-transit recurrence is a unique and uncommon pattern of treatment failure in patients with melanoma. Little information exists concerning the incidence, predictors, and natural history of in-transit disease since the introduction of sentinel lymph node biopsy (SLNB). Methods: Between 1991 and 2001, 1395 patients with primary melanoma underwent SLNB. Univariate and multivariate logistic regression analyses were performed to examine the association among known clinicopathologic factors, in-transit recurrence, and distant metastatic failure after the development of in-transit disease. Results: With a median follow-up of 3.9 years, 241 patients (17.3%) experienced disease recurrence, including 91 (6.6%) who developed in-transit recurrence. Independent predictors of in-transit recurrence included age >50 years, a lower extremity location of the primary tumor, Breslow depth, ulceration, and sentinel lymph node (SLN) status. Of the 69 patients who presented with in-transit disease as the sole site of first recurrence, 39 developed distant disease. By univariate analysis, predictors of distant failure among patients with in-transit disease included SLN status, largest metastatic focus in the SLN >2.5 mm2, subcutaneous location of in-transit disease, in-transit tumor size ≥ 2 cm, and a disease-free interval before in-transit recurrence of
KW - In transit
KW - Lymph node
KW - Melanoma
KW - Recurrence
KW - Sentinel lymph node biopsy
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U2 - 10.1245/ASO.2005.05.025
DO - 10.1245/ASO.2005.05.025
M3 - Article
C2 - 16021533
AN - SCOPUS:23744460937
SN - 1068-9265
VL - 12
SP - 587
EP - 596
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 8
ER -