Sentinel Lymph Node Biopsy in T4 XXXX : An Important Risk-Stratification Tool.

@entity1 @entity4298 @entity3 @entity320 @entity1349
BACKGROUND: Sentinel lymph node biopsy (SLNB) is a sensitive test for detecting subclinical nodal @entity3 in @entity1 with @entity320 without evidence of lymph node involvement. The prognostic significance of @entity4298 positivity in @entity1 with @entity320 >4  mm thick (T4) is unclear. The survival curves in the current AJCC staging system suggest that the status of the @entity4298 is not predictive of outcome for @entity1 with @entity320 . METHODS: @entity1 with primary @entity320 without clinical nodal involvement who underwent SLNB between 2002 and 2012 at Peter MacCallum Cancer Centre were included in the analysis with chart review performed to collect clinical, pathological, and outcome data. A meta-analysis was performed including similar studies of SLNB in @entity320 , which reported @entity1349 ( @entity1349 ) data. RESULTS: Of 217 @entity1 who underwent SLNB, 78 @entity1 had a positive @entity4298 (36  %). The 5-year @entity1349 for SLNB negative and positive @entity1 was 68 and 45  %, respectively [hazard ratio (HR) 2.82; 95  % CI 1.76-4.51; P  =  .001]. On multivariate analysis, the only predictors of @entity1349 were the status of the @entity4298 (HR 2.88; 95  % CI 1.75-4.73) and the presence of satellitosis (HR 2.59; 95  % CI 1.30-5.76). The meta-analysis identified 10 studies that met the inclusion criteria. All reported similar findings, demonstrating a significant difference in @entity1349 according to sentinel lymph node status; the pooled analysis of 2104 @entity1 demonstrated an overall HR for @entity1349 according to SLNB status of 2.3 (95  % CI 1.95-2.71). CONCLUSIONS: SLNB provides important prognostic information for @entity1 with @entity320 . This information is important when stratifying @entity1 for clinical trials.
