Sentinel Lymph Node Biopsy Use Among XXXX @entity1 75  Years of Age and Older.

@entity1 @entity320 @entity4298
INTRODUCTION: While @entity4298 biopsy is recommended for @entity320 >= 1  mm in depth, its use among the elderly population is more controversial. We reviewed our experience at the University of Michigan with @entity320 @entity1 >= 75  years of age. METHODS: A total of 952 @entity320 @entity1 >= 75  years of age from 1996 to 2011 were identified from our institutional review board-approved database. In addition to clinicopathologic features and outcome data, comorbidity data were collected to calculate the Charlson comorbidity index (CCI). Univariate and multivariate Cox regression analysis was performed to characterize predictors of outcome. Kaplan-Meier analysis was used to generate survival curves. RESULTS: Among 553 clinically node-negative @entity1 with @entity320 >= 1  mm in Breslow thickness, 213 had wide excision alone, whereas 340 had excision and @entity4298 biopsy, with 83 (24  %) having a positive @entity4298 . @entity4298 biopsy was less likely with older age (p  <  0.0001) and H_N location (p  =  0.007), but not CCI. @entity4298 involvement was associated with female gender [odds ratio (OR) 2.15, p  =  0.009], Breslow thickness [OR 1.23/mm increase, p  =  0.004], and satellitosis (OR 4.43, p  =  0.004). Distant disease-specific survival was negatively associated with male gender (OR 1.5, p  =  0.007), increasing age (OR 1.05/year, p  <  0.001), increasing Breslow thickness (OR 1.07/year, p  =  0.013), ulceration (OR 1.51, p  =  0.004), a positive @entity4298 (OR 2.61, p  <  0.001), and not having a @entity4298 biopsy (OR 1.72, p  <  0.001). CCI did not predict worse disease-free or @entity320 -specific survival. CONCLUSIONS: WLE and @entity4298 biopsy was not only strongly prognostic, but compared with WLE alone was associated with improved outcome, even after factoring for age and comorbidities. If otherwise healthy, @entity4298 biopsy should be strongly considered for this population.
