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Sentinel node biopsy versus elective lymph node dissection in patients with cutaneous melanoma in a Japanese population

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Abstract

Background

In Japan, elective lymph node dissection (ELND) has been the standard treatment for patients with possible nodal melanoma. Sentinel node biopsy (SNB) has now replaced ELND, not only in Japan but also worldwide. The objective of this study was to compare the interim outcomes of SNB and ELND.

Methods

A retrospective study was conducted among patients with clinically node-negative disease treated at our institute with either SNB (n = 30) or ELND (n = 72).

Results

The background was similar in the two groups. Nodal metastases were found in 40.0% of patients in the SNB group, but in only 26.4% in the ELND group (P = 0.173). The median follow-up was 31.5 months for the SNB group and 82 months for the ELND group. The incidence of locoregional recurrence and distant metastasis in the SNB group was 10.0% and 16.7%, respectively, and for the ELND group the incidence was 5.6% and 31.9%, respectively. The 3-year disease-free survival rate was similar in the two groups (P = 0.280), and the 3-year disease-free survival rates for node-positive patients were also similar in the two groups (P = 0.90), as were the 3-year disease-free survival rates for node-negative patients (P = 0.193).

Conclusion

This interim result in a Japanese melanoma population with clinically node-negative disease demonstrated that SNB identified more nodal micrometastases than ELND. This increase in accurate staging likely resulted from the reliable identification of the lymph node field by lymphoscintigraphy, as well as the more detailed pathologic examination of the nodes removed in SNB. It is quite reasonable to perform SNB instead of ELND in this population.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan

    Arata Tsutsumida, Hiroshi Furukawa & Yuhei Yamamoto

  2. Department of Plastic and Reconstructive Surgery, Sapporo City General Hospital, Sapporo, Japan

    Katsumi Horiuchi & Tetsunori Yoshida

  3. Department of Plastic and Reconstructive Surgery, Hokkaido Cancer Center, Sapporo, Japan

    Hidehiko Minakawa

  4. Department of Plastic and Reconstructive Surgery, Hakodate Municipal Hospital, Hakodate, Japan

    Satoru Fujii

  5. Department of Plastic and Reconstructive Surgery, Kushiro Rosai Hospital, Kushiro, Japan

    Naoki Murao

  6. Division of Plastic Surgery, Obihiro Kohsei General Hospital, Obihiro, Japan

    Hiroaki Kuwahara

  7. Department of Plastic and Reconstructive Surgery, Tomakomai Nisshou Hospital, Tomakomai, Japan

    Toshiyuki Minamimoto

  8. Department of Plastic and Reconstructive Surgery, Bibai Rosai Hospital, Bibai, Japan

    Hirotaka Fujioka

  9. Department of Plastic and Reconstructive Surgery, Nikko Memorial Hospital, Muroran, Japan

    Taisuke Sakamoto

  10. Department of Plastic and Reconstructive Surgery, Kitami Red Cross Hospital, Kitami, Japan

    Toyohiro Honma

Authors
  1. Arata Tsutsumida
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  2. Hiroshi Furukawa
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  3. Yuhei Yamamoto
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  4. Katsumi Horiuchi
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  5. Tetsunori Yoshida
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  6. Hidehiko Minakawa
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  7. Satoru Fujii
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  8. Naoki Murao
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  9. Hiroaki Kuwahara
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  10. Toshiyuki Minamimoto
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  11. Hirotaka Fujioka
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  12. Taisuke Sakamoto
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  13. Toyohiro Honma
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Corresponding author

Correspondence to Yuhei Yamamoto.

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Cite this article

Tsutsumida, A., Furukawa, H., Yamamoto, Y. et al. Sentinel node biopsy versus elective lymph node dissection in patients with cutaneous melanoma in a Japanese population. Int J Clin Oncol 12, 245–249 (2007). https://doi.org/10.1007/s10147-007-0667-9

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  • DOI: https://doi.org/10.1007/s10147-007-0667-9

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