Risk factors for positive sentinel lymph node, lymphatic or hematogenous dissemination over time in patients with cutaneous melanoma

Berghe,Alexandra S.; Cobzac,Gheorghe; Dindelegan,George; Șenilă,Simona C.; Baican,Corina I.; Solomon,Carolina M.; Rogojan,Liliana; Leucuța,Daniel C.; Drugan,Tudor C.; Bolboacă,Sorana D.

doi:10.3892/etm.2021.10162

Risk factors for positive sentinel lymph node, lymphatic or hematogenous dissemination over time in patients with cutaneous melanoma

Authors:
- Alexandra S. Berghe
- Gheorghe Cobzac
- George Dindelegan
- Simona C. Șenilă
- Corina I. Baican
- Carolina M. Solomon
- Liliana Rogojan
- Daniel C. Leucuța
- Tudor C. Drugan
- Sorana D. Bolboacă
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Affiliations: Department of Medical Informatics and Biostatistics, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400349 Cluj‑Napoca, Romania, Department of Nuclear Medicine, County Emergency Hospital Cluj‑Napoca, 400006 Cluj‑Napoca, Romania, Department of Surgery I, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, County Emergency Hospital Cluj‑Napoca, 400006 Cluj‑Napoca, Romania, Department of Dermatology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, County Emergency Hospital Cluj‑Napoca, 400006 Cluj‑Napoca, Romania, Department of Radiology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, County Emergency Hospital Cluj‑Napoca, 400006 Cluj‑Napoca, Romania, Department of Pathology, County Emergency Hospital Cluj‑Napoca, 400006 Cluj‑Napoca, Romania
Published online on: May 5, 2021 https://doi.org/10.3892/etm.2021.10162
Article Number: 730
Copyright: © Berghe et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to assess the influence of localization, age or sex and histopathological characteristics upon the chance of developing lymphatic or hematogenous metastatic spread over time, or a positive sentinel lymph node in cutaneous melanoma patients. Patients from the Department of Dermatology, County Emergency Hospital Cluj‑Napoca (Cluj‑Napoca, Romania), presenting with cutaneous melanoma confirmed histopathologically and a SPECT/CT or lymphoscintigraphic examination to detect the sentinel lymph node, were included in the present study. Our results revealed that Breslow index >2 mm [odds ratio (OR)=4.22, 95% confidence interval (CI) (1.12; 15.93)], presence of ulceration [OR=6.01, 95% CI (1.87; 19.35)], and positive sentinel lymph node [for at least one sentinel lymph node OR=3.58, 95% CI (1.06; 12.04)] were risk factors for hematogenous metastases. All these, except for the Breslow index >2 mm, were demonstrated to be a risk factor for lymphatic spread metastases over time. Ulceration and male sex also represented risk factors for a positive sentinel lymph node, men having a higher risk of developing sentinel lymph nodes than women [adjusted OR=2.27, 95% CI (1.00; 5.13)]. In conclusion, the predictors that influence the occurrence of lymphatic or hematogenous metastases may differ, ulceration and positive sentinel lymph node being common for both types of metastatic spread, while Breslow index being a significant predictor only for hematogenous metastases. Male sex and the presence of ulceration were demonstrated to be significant risk factors for positive sentinel lymph nodes.

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