Predictors of sentinel lymph node status and onset of regional lymph nodes metastases in melanoma.

INTRODUCTION: Several clinico-pathological characteristics such as age, sex, tumour localization, Breslow thickness, ulceration, mitotic count, vessel invasion and the presence of tumour-infiltrating lymphocytes have been identified as independent prognostic factors for relapse and overall survival of patients with skin melanoma. The aim of this study was to identify characteristics of primary melanoma which predict sentinel lymph node (SLN) positivity and the onset of regional lymph nodes metastases.

MATERIAL AND METHODS: A total of 60 patients who underwent surgery for malignant skin melanoma, divided into examined and control group, were analyzed. In the patients from the examined group SLN were marked with 1% solution of methylene blue, removed and histologically examined. The radical lymphadenectomy was performed as a separate procedure in the patients with SLN positive for metastasis. We analysed the differences in age, sex, tumour location, tumour area, primary tumour thickness, Clark levels of invasion, lymphocytic infiltration and presence of ulcerations in patients in the examined group and the control group and the correlation of the examined variables with the onset of metastases in the SLN.

RESULTS: The results showed that the differences between the groups were statistically significant only for the primary melanoma thickness and the Clark level of invasion. There was a significant difference in the intensity of the lymphocytic infiltration between the SLN negative patients and the patients from the control group. A statistically significant correlation with SLN positive status was found only with the Clark level of invasion.