0.75mm Breslow Index as Standard Cut-off in Sentinel Lymph Node Biopsy for Melanoma

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author MOUTINHO, V. FMUSP-HC
dc.date.issued 2012
dc.identifier.citation ANNALS OF SURGICAL ONCOLOGY, v.19, suppl.1, p.S127-S127, 2012
dc.identifier.issn 1068-9265
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/2667
dc.description.abstract Introduction: Breslow index is the most important risk factor for melanoma progression. Breslow index cutoff to perform sentinel node biopsy is not consensual among institutions worldwide. Our study aims to discuss if 0.75mm is an adequate cut-off for sentinel node biopsy for melanoma. Methods: Retro- spective charts from initial 115 patient files from May/2008 to June/2011 were analyzed. Sentinel lymph node biopsy was routinely carried out in patients with Breslow >0.75mm and in high risk patients with Breslow < or =0.75mm (pres-ence of ulceration, regression, mitoses and Clark levels IV/V). Two groups were defined based on Breslow: (A) < or =1.00mm - major group with 17 patients; (B) 0.76-1.00mm - subgroup of 5 patients at threshold for sentinel biopsy. Both groups were compared with Breslow > 1.00 patients as Control Group, using Fischer’s test. High risk of recurrence characteristics were reviewed in patients with Breslow <0.76mm and expressed as percentages. Results: Sen- tinel lymph node biopsies were positive in 40,5% (15/37) of melanomas with Breslow >1.00mm. In patients with Breslow < or =1.00mm (A) there was 5.8% (1/17) sentinel node positivity. In the subgroup of patients with Breslow 0.76- 1.00mm (B) sentinel nodes were positive in 20% (1/5). When testing statisti- cally, Group A (< or =1.00mm) was different from Control group patients (> 1.00mm) regarding sentinel node positivity (p=0.008), while Group B (0.75- 1.00 mm) was similar to Control group patients (p=0.35). In patients with Bres- low <0.76 mm with high risk characteristics on pathologic report, ulceration was not present in any patient, 16,7% were Clark levels IV/V, mitoses were present in 70% of patients, lesions were in vertical phase of growth in 40% and regression was present in 36%. Conclusions: 1. Sentinel node biopsy in melanomas with Breslow 0.76-1.00mm should be routinely indicated due to a high positivity rate (20% in our sample) in this range. 2. Node positivity in patients with Breslow <0.76mm (5.8%) was statistically different from node positivity in Breslow >1.00mm group (40%; p=0.008) rising the question that indication of sentinel node biopsy in Breslow <0.76mm is controversial.
dc.language.iso eng
dc.publisher SPRINGER
dc.relation.ispartof Annals of Surgical Oncology
dc.rights restrictedAccess
dc.title 0.75mm Breslow Index as Standard Cut-off in Sentinel Lymph Node Biopsy for Melanoma
dc.type conferenceObject
dc.rights.holder Copyright SPRINGER
dc.description.conferencedate MAR 21-24, 2012
dc.description.conferencelocal Orlando - FL, EUA
dc.description.conferencename 65th Annual Cancer Symposium of the Society-of-Surgical-Oncology (SSO)
dc.description.group LIM/62
dc.type.category meeting abstract
dc.type.version publishedVersion
hcfmusp.author MOUTINHO, V.:HC:ICHC
hcfmusp.author AKAISHI, E.:hC:ICHC
hcfmusp.author UTIYAMA, E.:FM:MCG
hcfmusp.author PERINA, A.:HC:ICESP
hcfmusp.author RASSLAN, S.:FM:MCG
hcfmusp.author.external · MENDES, G.:FMUSP, ICESP Canc Inst, Sao Paulo, Brazil
· TEIXEIRA, F.:FMUSP, ICESP Canc Inst, Sao Paulo, Brazil
· FERREIRA, F.:FMUSP, ICESP Canc Inst, Sao Paulo, Brazil
hcfmusp.origem.id WOS:000310202700372
hcfmusp.publisher.city NEW YORK
hcfmusp.publisher.country USA
dc.description.index MEDLINE
hcfmusp.citation.wos 0
hcfmusp.affiliation.country Brasil

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