Annals of Surgical Oncology

, Volume 10, Issue 4, pp 403–407

Sentinel Lymph Node Biopsy for Patients With Cutaneous Desmoplastic Melanoma

Authors

  • David E. Gyorki
    • Department of SurgeryMemorial Sloan-Kettering Cancer Center
  • Klaus Busam
    • Department of Surgical PathologyMemorial Sloan-Kettering Cancer Center
  • Kathy Panageas
    • Department of BiostatisticsMemorial Sloan-Kettering Cancer Center
  • Mary Sue Brady
    • Department of Surgical PathologyMemorial Sloan-Kettering Cancer Center
    • Department of SurgeryMemorial Sloan-Kettering Cancer Center
    • Gastric and Mixed Tumor ServiceMemorial Sloan-Kettering Cancer Center
Original Articles

DOI: 10.1245/ASO.2003.04.003

Cite this article as:
Gyorki, D.E., Busam, K., Panageas, K. et al. Ann Surg Oncol (2003) 10: 403. doi:10.1245/ASO.2003.04.003

Abstract

Background: Although desmoplastic melanoma (DM) often presents at a locally advanced stage, nodal metastases are rare. We describe our experience with lymphatic mapping and sentinel lymph node biopsy (SLNB) in patients with DM to characterize the biological behavior of these tumors.

Methods: Twenty-seven patients with cutaneous DM underwent wide excision and attempted SLNB between 1996 and 2001. All pathology was reviewed by a single dermatopathologist (KB). Clinical and histological features were recorded.

Results: There were 20 male and 7 female patients. The median age was 64 years (range, 35–83 years). The head and neck was the most commonly involved anatomical region (n = 14). The median Breslow thickness was 2.2 mm. Twenty-four patients underwent successful SLNB. No patient had a positive sentinel node. At a median follow-up of 27 months, five patients recurred (four systemic and one local); all five had undergone successful SLNB. Two of these patients died of disease, two are alive with disease, and one remains alive and disease free. No patient experienced failure in a regional nodal basin.

Conclusions:DM is a biologically distinct form of melanoma, with a very low incidence of regional lymph node metastases, either at presentation or in long-term follow-up. This biology should be considered when designing rational treatment strategies for these patients.

Key Words:

Desmoplastic melanomaSentinel lymph node biopsyLocal recurrenceSurvival

Copyright information

© The Society of Surgical Oncology, Inc. 2003