The Rotterdam criteria are used to characterize metastases to sentinel lymph nodes in patients with malignant melanoma.
Patient selection: one or more metastases to a sentinel lymph node
Proceedure:
(1) The maximum diameter of each lymph node metastasis is recorded.
(2) The maximum diameter of all foci is used for analysis.
|
Maximum Diameter |
Tumor Burden |
|
< 0.1 mm |
low |
|
0.1 to 1.0 mm |
intermediate |
|
> 1.0 mm |
high |
|
Maximum Diameter |
Positive Nonsentinel LN (van Akkooi 2008) |
Positive Nonsentinel LN (van der Ploeg) |
|
< 0.1 mm |
3% |
0% |
|
0.1 to 1.0 mm |
21% |
3% |
|
> 1.0 mm |
32% |
18% |
|
Maximum Diameter |
Overall 5 Year Survival (van Akkooi 2006) |
Overall 5 Year Survival (van Akkooi 2008) |
Overall 5 Year Survival (van der Ploeg et al) |
|
< 0.1 mm |
100% |
91% |
100% |
|
0.1 to 1.0 mm |
63% |
61% |
84% |
|
> 1.0 mm |
35% |
51% |
68% |
Interpretation:
• A patient with a micrometastases < 0.1 mm in maximum diameter has a good prognosis and does need to undergo a completion lymph node dissection.
• The features of the malignant melanoma patients differ in the various studies which contributes to the differences in survival.
Limitation:
• The total number of sentinel lymph nodes removed and the total number showing a metastasis is not included in the analysis.
Specialty: Hematology Oncology, Surgery, general, Dermatology
