Popliteal sentinel lymph node involvement in melanoma patients

• Published in: Journal of surgical oncology Vol. 112; no. 2; pp. 179 - 182
• Main Authors: Bertolli, Eduardo, Bevilacqua, José Luiz Barbosa, Molina, André Sapata, de Macedo, Mariana Petaccia, Pinto, Clovis Antonio Lopes, Duprat Neto, João Pedreira
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.08.2015; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Lower Extremity; Lymph Node Excision; Lymph Nodes - pathology; Lymph Nodes - surgery; lymphatic metastasis; Lymphatic Metastasis - diagnosis; Male; melanoma; Melanoma - pathology; Melanoma - surgery; Middle Aged; Popliteal Vein; Retrospective Studies; Sentinel Lymph Node Biopsy; Skin Neoplasms - pathology; Skin Neoplasms - surgery; melanoma; lymphatic metastasis; sentinel lymph node biopsy
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.23978

Background Sentinel lymph nodes (SLN) in popliteal basins are rare, and there is controversy in literature regarding their origin, management, and outcomes. Objectives To correlate clinical and pathological features of popliteal basin drainage and analyze the impact of popliteal lymph node drainage on survival. Materials and Methods Retrospective analysis of SLN biopsies performed at a single institution between 2000 and 2010. Results SLN biopsies were performed in 254 patients with melanoma in lower limbs, 247 of which were evaluated. In this group, there were 59 patients (24%) with a positive SLN. Twenty‐seven cases (11%) presented with popliteal drainage, one of which lacked concurrent groin drainage. Among these 27 patients, three (11%) had popliteal metastasis, one of which had exclusive involvement of this basin. Popliteal drainage was associated with worse 5‐year disease‐free survival (DFS) (P = 0.028) but not 5‐year overall survival (OS) (P = 0.219) in univariate analysis. In multivariate analysis, Breslow thickness, mitotic index, and positive SLN were prognostic factors for DFS. Only mitotic index correlated significantly with OS (P = 0.044). Conclusions Popliteal drainage seems to be associated with worse prognostic features of the primary tumor. J. Surg. Oncol. 2015 111:179–182. © 2015 Wiley Periodicals, Inc.