(HealthDay News) — Nonsentinel lymph node (NSLN) positivity is a significant prognostic factor in patients with stage III melanoma, associated with shorter overall and disease-specific survival, according to research published online July 31 in JAMA Surgery.

Anna M. Leung, M.D., of St. John’s Health Center in Santa Monica, Calif., and colleagues searched the database at the John Wayne Cancer Institute and identified patients with sentinel lymph nodes (SLNs) positive for cutaneous melanoma who subsequently underwent completion lymph node dissection. The survival associated with disease limited to SLNs and disease spread into NSLNs was examined.

The researchers found that 329 of 4,223 patients who underwent SLN biopsy from 1986 to 2012 had a tumor-positive SLN. Of these, 250 patients (76.0%) had no additional positive nodes and 79 patients (24.0%) had a tumor-positive NSLN.

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The NSLN-positive group had shorter overall median survival (42.2 versus 178 months), lower rate of five-year overall survival (46.4% versus 72.3%), shorter median melanoma-specific survival (60 months versus not yet reached), and lower rate of five-year melanoma-specific survival (49.5% versus 77.8%) than the SLN-only positive group.

“We propose that, for the next iteration of the staging system, the committee performs an analysis of the independent prognostic impact of NSLN status,” the authors write.