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The Prognostic Importance of Sentinel Lymph Node Biopsy in Thin Melanoma

Annals of Surgical Oncology volume 13, pages 927–932 (2006)Cite this article

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Abstract

Background

Sentinel lymph node biopsy (SLNB) is prognostically useful in patients with cutaneous melanoma with Breslow thickness >1 mm. The objective of this study was to determine whether sentinel node histology has similar prognostic importance in patients with thin melanomas (≤1 mm).

Methods

This was a retrospective study of patients who underwent SLNB for clinically localized melanoma at Indiana University Medical Center between 1994 and 2003. SLNB results and traditional melanoma prognostic indicators were studied in univariate log-rank tests.

Results

One hundred eighty-four patients with melanomas ≤1 mm thick underwent SLNB. SLNB was tumor positive in 12 patients (6.5%). Univariate analysis of SLNB results revealed that Breslow thickness, Clark level of invasion, and mitotic index were associated with SLNB status. Tumor positivity was observed at different rates in tumor thickness subsets: <.75 mm, 2.3%; and .75 to 1.0 mm, 10.2% (P = .0372). Disease-free survival and overall survival were significantly associated with SLNB results in melanomas ≤1 mm (log-rank test: P < .0001 and P = .0125, respectively) at a median follow-up of 26.3 months.

Conclusions

SLNB histology in melanomas ≤1.0 mm deep is a significant predictor of outcome. SLNB should be considered for selected patients with melanomas .75 to 1.0 mm.

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Fig. 1

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Authors and Affiliations

  1. Department of Surgery/Plastic and Reconstructive Surgery, Indiana University School of Medicine, Indiana University–Purdue University, Indianapolis, Indiana, 46202

    Jaime M. Ranieri MD, Jeffrey D. Wagner MD, Stacie Wenck RNP & John J. Coleman III MD

  2. Department of Medicine/Biostatistics, Indiana University School of Medicine, Indiana University–Purdue University, Indianapolis, Indiana, 46202

    Cynthia S. Johnson MA

Authors
  1. Jaime M. Ranieri MD
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  2. Jeffrey D. Wagner MD
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  3. Stacie Wenck RNP
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  4. Cynthia S. Johnson MA
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  5. John J. Coleman III MD
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Correspondence to Jeffrey D. Wagner MD.

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Ranieri, J.M., Wagner, J.D., Wenck, S. et al. The Prognostic Importance of Sentinel Lymph Node Biopsy in Thin Melanoma. Ann Surg Oncol 13, 927–932 (2006). https://doi.org/10.1245/ASO.2006.04.023

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  • DOI: https://doi.org/10.1245/ASO.2006.04.023

Keywords

  • Melanoma
  • Metastases
  • Sentinel lymph node
  • Prognosis
  • Tumor thickness
  • Breslow level