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Sentinel lymph node biopsy benefited cutaneous melanoma patients

Sentinel lymph node biopsy was accurate and reliable as a staging method in patients with cutaneous melanoma, according to study results.

Researchers in France observed a single-center cohort of 203 patients (mean age, 55.8 years; 50.7% women) with a primary cutaneous melanoma (CM) and a tumor thickness of at least 1 mm without evidence of metastasis who underwent sentinel lymph node biopsy from 2002 to 2009. A preoperative lymphocintigraphy and a hand-held gamma probe were used to identify sentinel lymph node (SLN).

SLN was identified in 197 patients, and 44 were tumor positive. Positive SLN and negative SLN patients showed differences for primary tumor thickness (2.8 mm vs. 1.6 mm; P=.00289), ulceration presence (47.7% vs. 24.2%; P=.008) and T stage (P=.0172) in primary CM. Forty-two patients with positive SLN (95%) underwent complete lymph node dissection (CLND). Follow-up was a median duration of 39.5 months, with median time for recurrence of 12 months.

SLN positive patients had significantly more frequent disease progression compared with SLN negative patients (32% vs. 13%; P=.002). For the entire cohort, 5-year disease-free survival (DFS) and overall survival (OS) were 79.6% and 84.6%, respectively. SLN negative patients had higher 5-year DFS (85% vs. 58.7; P=.0006) and OS (90.3% vs. 69.7%; P=.0096) than SLN positive patients. Twelve percent of patients experienced postoperative complications after SLN biopsy.

“Our retrospective study confirms the results of SLN analysis in patients with melanoma with tumor thickness greater than 1 mm,” the researchers concluded. “The main benefit of this analysis was the prognostic value in terms of relapse and survival [as long as additional lymph node excision was performed], and its high predictive negative value. … Although already recommended, evaluating the benefit of additional CLND after positive SLN is necessary.”