Prognostic factors of appearing micrometastases in sentinel lymph nodes in skin melanoma
Summary. For many years, the search of demographic, clinical and histological factors that have predictive value for the appearence melanoma micrometastases in sentinel lymph nodes (SLN) is conducted. The most significant of them are the tumor thickness by Breslow more than 1,0 mm, the level of invasion by Clark IV–V and ulceration of the primary tumor. In addition, some studies have shown that the mitotic rate >0, the absence of tumor-infiltrating lymphocytes, male sex, the regression of primary tumor also increase the risk of SLN metastasis. Prognostic factors influencing on the incidence of micrometastases in SLN are studied on the example of 156 patients with primary melanoma who were treated in National Cancer Institute. Such factors as the localization of the primary tumor on the body and tumor thickness by Breslow more than 4 mm are significant. The optimal threshold value of tumor thickness by Breslow for prediction SLN metastasis is 2,5 mm. This threshold is characterized of maximum sensitivity (86,2%) and specificity (68,5%). Younger age of patients is also associated with increased incidence of micrometastases, but these data are not statistically significant.
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