Age as a Predictor of Sentinel Node Metastasis among Patients with Localized Melanoma: An Inverse Correlation of Melanoma Mortality and Incidence of Sentinel Node Metastasis Among Young and Old Patients

作者：Balch Charles M^*; Thompson John F; Gershenwald Jeffrey E; Soong Seng jaw; Ding Shouluan; McMasters Kelly M; Coit Daniel G; Eggermont Alexander M M; Gimotty Phyllis A; Johnson Timothy M; Kirkwood John M; Leong Stanley P; Ross Merrick I; Byrd David R; Cochran Alistair J; Mihm Martin C Jr; Morton Donald L; Atkins Michael B; Flaherty Keith T; Sondak Vernon K

来源：Annals of Surgical Oncology, 2014, 21(4): 1075-1081.

DOI：10.1245/s10434-013-3464-x

Purpose. We have previously reported that older patients with clinical stage I and II primary cutaneous. Melanoma had lower survival rates compared to younger patients. We postulated that the incidence of nodal metastasis would therefore be higher among older melanoma patients. %26lt;br%26gt;Methods. The expanded American Joint Committee on Cancer melanoma staging database contains a cohort of 7,756 melanoma patients who presented without clinical evidence of regional lymph node or distant metastasis and who underwent a sentinel node biopsy procedure as a component of their staging assessment. %26lt;br%26gt;Results. Although older patients had primary melanoma features associated with more aggressive biology, we paradoxically observed a significant decrease in the incidence of sentinel node metastasis as patient age increased. Overall, the highest incidence of sentinel node metastasis was 25.8 % in patients under 20 years of age, compared to 15.5 % in patients 80 years and older (p %26lt; 0.001). In contrast, 5-year mortality rates for clinical stage II patients ranged from a low of 20 % for those 20-40 years of age up to 38 % for those over 70 years of age. Patient age was an independent predictor of sentinel node metastasis in a multifactorial analysis (p %26lt; 0.001). %26lt;br%26gt;Conclusions. Patients with clinical stage I and II melanoma under 20 years of age had a higher incidence of sentinel lymph node metastasis but, paradoxically, a more favorable survival outcome compared to all other age groups. In contrast, patients %26gt; 70 years had the most aggressive primary melanoma features and a higher mortality rate compared to all other age groups but a lower incidence of sentinel lymph node metastasis.

• 出版日期2014-4