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Improved Staging of Node-Negative Patients With Intermediate to Thick Melanomas (>1 mm) With the Use of Lymphatic Mapping and Sentinel Lymph Node Biopsy

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Abstract

Background: Elective lymph node dissection ELND may contribute to a survival benefit in certain stratified subsets of melanoma patients. We hypothesized that lymphatic mapping and sentinel lymph node SLN biopsy with complete node dissection if metastases are present may improve both staging and survival of patients with clinically negative nodes, without subjecting all patients to the morbidity associated with complete ELND.

Methods: We reviewed the data for all 14,914 N0 patients of the AJCC Melanoma Staging Database to determine the effect of SLN biopsy and ELND on staging and survival.

Results: Retrospective analysis revealed that there was an apparent statistically significant survival advantage to SLN biopsy in patients with melanomas >1 mm n = 9024; 68.5% and 26.2% reduction in mortality compared with patients staged to be N0 by clinical exam and ELND, respectively; P < .0001. Five-year survivals were 90.5%, 77.7%, and 69.8%, respectfully, for patients staged by SLN biopsy n = 2552, ELND n = 2014, and clinical examination alone n = 5192. The survival advantage of SLN biopsy was statistically significant for each T-stage category T2, T3, and T4 and ulceration status. There was no advantage to SLN biopsy in patients with melanomas <1 mm n = 5890.

Conclusions: SLN biopsy provides more accurate staging and may contribute to a survival benefit in populations of patients with melanoma.

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Authors and Affiliations

  1. H. Lee Moffitt Cancer Center SD, DR, University of South Florida, Tampa, Florida

    Sophie Dessureault MD, Daniel G. Coit MD & Douglas Reintgen MD

  2. the University of Alabama at Birmingham S-JS, Birmingham, Alabama

    Seng-Jaw Soong PhD

  3. the M. D. Anderson Cancer Center MIR, University of Texas, Houston, Texas

    Merrick I. Ross MD

  4. the Sydney Melanoma Unit JFT, University of Sydney, Sydney, Australia

    John F. Thompson MD

  5. the University of Pittsburgh Medical Center JMKZ, Pittsburgh, Pennsylvania

    John M. Kirkwood MD

  6. the University of Louisville Medical Center KMM, Louisville, Kentucky

    Kelly M. McMasters MD

  7. the John Hopkins Medical Center CMB, Baltimore, Maryland

    Charles M. Balch MD

  8. H. Lee Moffitt Cancer Center, Suite 3125, 12901 Magnolia Drive, Tampa, FL, 33612

    Sophie Dessureault MD

  9. H. Lee Moffitt Cancer Center, 12901 Magnolia Drive, Tampa, FL, 33612

    Douglas Reintgen MD

Authors
  1. Sophie Dessureault MD
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  2. Seng-Jaw Soong PhD
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  3. Merrick I. Ross MD
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  4. John F. Thompson MD
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  5. John M. Kirkwood MD
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  6. Daniel G. Coit MD
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  7. Kelly M. McMasters MD
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  8. Charles M. Balch MD
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  9. Douglas Reintgen MD
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Corresponding authors

Correspondence to Sophie Dessureault MD or Douglas Reintgen MD.

Additional information

*Members of the AJCC Melanoma Staging Committee: Charles M. Balch, MD, Antonio C. Buzaid, MD, Seng-Jaw Soong, PhD, Michael B. Atkins, MD, Natale Cascinelli, MD, Daniel G. Coit, MD, Irvin D. Fleming, MD, Jeffrey E. Gershenwald, MD, Alan Houghton Jr., MD, John M. Kirkwood, MD, Kelly M. McMasters, MD, Martin F. Mihm, MD, Donald L. Morton, MD, Douglas S. Reintgen, MD, Merrick I. Ross, MD, Arthur Sober, MD, John A. Thompson, MD, and John F. Thompson, MD.

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Dessureault, S., Soong, SJ., Ross, M.I. et al. Improved Staging of Node-Negative Patients With Intermediate to Thick Melanomas (>1 mm) With the Use of Lymphatic Mapping and Sentinel Lymph Node Biopsy. Ann Surg Oncol 8, 766–770 (2001). https://doi.org/10.1007/s10434-001-0766-1

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  • DOI: https://doi.org/10.1007/s10434-001-0766-1

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