To assess the prognostic role of sentinel lymph node status (SLN) in melanoma patients,
a statistical comparison was performed with the application of already known prognostic
factors, mutational occurrence of BRAF and NRAS in the primary tumor, as well as disease
outcome.Our retrospective single-center study involved 159 melanoma cases, who underwent
SLN biopsy. The following clinico-pathological data were collected: age, gender, location
of primary tumor, Breslow thickness, ulceration degree, histological subtype, mitosis
count, lymphovascular and perineural invasion, presence of tumor-infiltrating lymphocytes,
regression signs, mutations of BRAF and NRAS of the primary tumors, and SLN status.From
the studied clinico-pathological factors, only Breslow thickness increased the risk
of SLN positivity (p = 0.025) by multivariate analysis, while neither BRAF nor NRAS
mutation of the primary tumor proved to be a predictor of the SLN status. While the
NRAS-mutant subgroup showed the most unfavorable outcome for progression-free and
distant metastasis-free survival, their rate of positive SLNs proved to be relatively
lower than that of patient groups with BRAF mutation and double-wild-type phenotypes.Similarly
to the importance of SLN positivity, NRAS mutation of the primary tumor proved to
be an independent prognostic factor of progression. Therefore, despite negative SLN,
this NRAS-mutant subgroup of patients still requires closer monitoring to detect disease
progression.
