Article Figures & Tables
Figures
- Fig. 1
(A) SLNB indication and completion by the eighth edition of the AJCC Cancer Staging Manual, (B) age at diagnosis and (C) primary tumour site. SLNB = sentinel lymph node biopsy.
- Fig. 2
Kaplan–Meier analysis for all patients based on noncompliance with SLNB guidelines. Analyses were performed for patients with melanoma at both stages I and II (A), stage I only (B) and stage II only (C). SLNB = sentinel lymph node biopsy.
- Fig. 3
Kaplan–Meier analysis for patients aged 75 years and younger based on noncompliance with SLNB guidelines. Analyses were performed for patients with melanoma at both stages I and II (A), stage I only (B) and stage II only (C). SLNB = sentinel lymph node biopsy.
Tables
Society Year Breslow depth SLNB recommendation NCCN 2019 < 0.8 mm without ulceration Not recommended < 0.8 mm with ulceration Discuss and consider 0.8–1.0 mm Discuss and consider > 1.0 mm Recommended ASCO-SSO 2018 < 0.8 mm without ulceration Not recommended < 0.8 mm with ulceration Discuss and consider 0.8–1.0 mm Discuss and consider 1.01–4.0 mm Recommended > 4.0 mm May be recommended ESMO 2019 < 0.8 mm without ulceration Not recommended < 0.8 mm with ulceration Recommended 0.8–1.0 mm Recommended > 1.0 mm Recommended CCO 2019 < 0.8 mm without ulceration Not recommended < 0.8 mm with high-risk features* Discuss and consider 0.8–1.0 mm Discuss and consider 1.01–4.0 mm Recommended > 4.0 mm Discuss and consider ASCO-SSO = American Society of Clinical Oncology and Society of Surgical Oncology; CCO = Cancer Care Ontario clinical practice guideline22; ESMO = European Society for Medical Oncology; NCCN = National Comprehensive Cancer Network; SLNB = sentinel lymph node biopsy.
↵* High-risk features include Clark level IV or V, mitotic rate ≥ 1/ mm2, ulceration or microsatellites.
Characteristic No. (%) of patients*
n = 759Age, yr < 50 128 (16.9) 50–75 401 (52.8) > 75 230 (30.3) Female 330 (43.5) Location of primary tumour Extremity 333 (43.9) Trunk 255 (33.6) Head and neck 171 (22.5) Definitive wide local excision 718 (94.6) Breslow depth, mm ≤ 1.0 189 (24.9) 1.01–4.0 429 (56.5) > 4.0 141 (18.6) Ulceration 172 (22.7) Mitotic rate (mitoses/mm2) < 1 160 (21.1) ≥ 1 599 (78.9) Lymphovascular invasion 19 (2.5) Clinical stage† IA 96 (12.6) IB 347 (45.7) IIA 134 (17.7) IIB 96 (12.6) IIC 85 (11.2) Clinical stage‡ IA 9 (11.9) IB 435 (57.3) IIA 132 (17.4) IIB 97 (12.8) IIC 85 (11.2) ↵* Percentages in some categories may sum to less than 100% because of missing data.
↵† TNM stage determined on the basis of the seventh edition of the American Joint Committee on Cancer’s AJCC Cancer Staging Manual.
↵‡ TNM stage determined on the basis of the eighth edition of the American Joint Committee on Cancer’s AJCC Cancer Staging Manual.
Variable No. of patients OR (95% CI) p value SLNB done SLNB not done Age, yr 50–75 223 177 0.55 (0.33–0.91) 0.021 > 75 68 162 0.15 (0.09–0.26) < 0.001 Location of primary tumour Trunk 124 131 0.50 (0.33–0.76) 0.001 Head and neck 51 119 0.23 (0.14–0.36) < 0.001 Breslow depth, mm 1.01–4.0 283 145 17.0 (10.3–29.3) < 0.001 > 4.0 58 83 6.8 (3.6–13.0) < 0.001 Mitotic rate, ≥ 1 mitoses/mm2 325 273 1.8 (1.1–2.9) 0.040 Lymphovascular invasion 13 6 3.3 (1.1–11.2) 0.041 CI = confidence interval; OR = odds ratio; SLNB = sentinel lymph node biopsy.
Variable No. of patients OR (95% CI) p value SLNB done SLNB not done Location of primary tumour Trunk 102 93 0.33 (0.19–0.57) < 0.001 Head and neck 38 55 0.17 (0.09–0.32) < 0.001 Breslow depth, mm 1.01–4.0 236 73 27.6 (14.9–54.1) < 0.001 > 4.0 46 19 17.8 (7.6–43.7) < 0.001 Ulceration 74 21 2.11 (1.10–4.14) 0.028 Mitotic rate, ≥ 1 mitoses/mm2 267 138 1.90 (1.00–3.33) 0.040 CI = confidence interval; OR = odds ratio; SLNB = sentinel lymph node biopsy.
Breslow depth, mm No. (%) of patients Regional recurrence Distant recurrence < 1.0 4 (2) 0 (0) 1.01–4.0 35 (8) 26 (6) > 4.0 33 (23) 40 (28)
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