Annals of Surgical Oncology

, Volume 20, Issue 8, pp 2780–2786 | Cite as

Sentinel Node Biopsy in Thin and Thick Melanoma

  • Nicola Mozzillo
  • Elisabetta Pennacchioli
  • Sara Gandini
  • Corrado Caracò
  • Anna Crispo
  • Gerardo Botti
  • Secondo Lastoria
  • Massimo Barberis
  • Francesco Verrecchia
  • Alessandro Testori
Melanomas

Abstract

Background

Although sentinel node biopsy (SNB) has become standard of care in patients with melanoma, its use in patients with thin or thick melanomas remains a matter of debate.

Methods

This was a retrospective analysis of patients with thin (≤1 mm) or thick (≥4 mm) melanomas who underwent SNB at two Italian centers between 1998 and 2011. The associations of clinicopathologic features with sentinel lymph node positive status and overall survival (OS) were analyzed.

Results

In 492 patients with thin melanoma, sentinel node was positive for metastatic melanoma in 24 (4.9 %) patients. No sentinel node positivity was detected in patients with primary tumor thickness <0.3 mm. Mitotic rate was the only factor significantly associated with sentinel node positivity (p = 0.0001). Five-year OS was 81 % for patients with positive sentinel node and 93 % for negative sentinel node (p = 0.001). In 298 patients with thick melanoma, 39 % of patients had positive sentinel lymph nodes (median Breslow thickness 5 mm). In patients with positive sentinel node, 93 % had mitotic rate >1/mm2. Five-year OS was 49 % for patients with positive sentinel lymph nodes and 56 % for patients with negative sentinel nodes (p = 0.005).

Conclusions

The rate of sentinel node positivity in patients with thin melanoma was 4.9 %. The only clinicopathologic factor related to node positivity was mitotic rate. Given its prognostic importance, SNB should be considered in such patients. SNB should also be the standard method for melanoma ≥4 mm, not only for staging, but also for guiding therapeutic decisions.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Nicola Mozzillo
    • 1
  • Elisabetta Pennacchioli
    • 2
  • Sara Gandini
    • 2
  • Corrado Caracò
    • 1
  • Anna Crispo
    • 1
  • Gerardo Botti
    • 1
  • Secondo Lastoria
    • 1
  • Massimo Barberis
    • 2
  • Francesco Verrecchia
    • 2
  • Alessandro Testori
    • 2
  1. 1.Istituto Nazionale per lo Studio e la cura dei tumori “Fondazione G.Pascale” IRCCSNaplesItaly
  2. 2.European Institute of OncologyMilanItaly

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