To the Editors:
We read with interest the paper by Morris and colleagues1 in which, on a much larger scale, conclusions of our small study from the Department of Dermatology of the University Hospital Spedali Civili of Brescia, Italy2 have been confirmed. Between January 1996 and December 2004 we performed sentinel lymph node biopsy (SNB) in 50 patients with histopathologically “favourable” melanoma (tumor thickness less than or equal to 0.75 mm, Clark level II or III, no ulceration) showing regression according to the criteria proposed by the Pathological Group of the World Health Organization Melanoma Programme.3 From the 50 patients with thin melanoma, a total of 79 lymph nodes were analyzed using multilevel sections of paraffin-embedded specimens stained for melanoma markers S100 and MART-1 or HMB45, as previously described.4 None of the 79 nodes was found to contain melanoma metastases. We concluded that tumor regression in thin melanomas is not associated with a significant risk of sentinel lymph node involvement. Now, with the study of Morris and colleagues, our hypothesis has found a major confirmation.
References
Morris KT, Busam KJ, Bero S, Patel A, Brady MS. Primary cutaneous melanoma with regression does not require a lower threshold for sentinel lymph node biopsy. Ann Surg Oncol 2008;15:316–22
Manganoni AM, Farisoglio C, Farfaglia R, et al. Regression in thin melanomas does not represent a risk factor for sentinel lymph node involvement. Eur J Dermatol 2007;17:95–6
Clemente C, Cook M, Ruiter DJ, Mihm MC on behalf of WHO Melanoma Programme. (1998) Histopathologic diagnosis of melanoma, 5th booklet. Milan: Grafiche Rekord
Manca G, Facchetti F, Pizzocaro C, et al. Nodal staging in localized melanoma. The experience of the Brescia Melanoma Unit. Br J Plast Surg 2003;56:534–9
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Manganoni, A.M., Farisoglio, C., Facchetti, F. et al. Sentinel Lymph Node Biopsy in Melanoma: Assessment of Risk. Ann Surg Oncol 15, 2626 (2008). https://doi.org/10.1245/s10434-008-9942-x
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DOI: https://doi.org/10.1245/s10434-008-9942-x