Sentinel node metastasectomy in thin <or=1-mm melanoma.
OBJECTIVE
Sentinel lymph node biopsy (SLNB) has been widely accepted as a precise tool to stage melanoma. In thin T1 melanomas (<or=1 mm), the indication of SLNB is controversial since the risk of nodal metastasis is low. The aim of this study was to assess if SLNB detects occult nodal metastases among patients with thin melanomas.


METHODS
SLNB was performed prospectively in 135 patients with invasive melanoma in any depth category, including 56 T1 melanomas.


RESULTS
Nodal metastases were detected in 18% by SLNB, and there were three sentinel-positive thin melanomas, constituting 5% of the T1 cases. Histopathologically, there were no factors of the primary tumors that would have predicted these metastases.


CONCLUSIONS
SLNB is a precise method to detect clinically silent nodal metastases in thin invasive melanoma. Certain histopathologic features of a thin primary lesion may correlate with the predictive probability of the sentinel node status. We were unable to identify these predictors, but the conclusions from this study are limited by the small sample size. Advanced melanoma is a lethal disease, and accurate staging is essential also in the T1 group. For stage III patients with occult nodal metastases, metastasectomy is a better option for cure than observation.
Koskivuo
Ilkka
I
Department of Surgery, Turku University Hospital, P.O. Box 52, 20521, Turku, Finland. ilkka.koskivuo@tyks.fi
Suominen
Erkki
E
Niinikoski
Juha
J
Talve
Lauri
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*