Sentinel lymph node involvement and a high Breslow index are independent factors of risk for early relapse of melanoma.
OBJECTIVE
The clinical relevance of sentinel lymph node (SLN) analysis was evaluated prospectively and compared with other known risk factors of relapse in early stage melanoma.


METHODS
Surgery was guided by lymphoscintigraphy, blue dye and gamma probe detection. SLN were analysed by haematoxylin eosin (HE) histochemistry and multimarker immunohistochemistry (IHC). Disease free survival (DFS) was evaluated with Kaplan-Meier plots according to different parameters and Cox analyses of variance.


RESULTS
From 210 patients a total of 381 SLN were excised. Lymphoscintigraphy identified all excised SLN with only 2 false positive lymphatic lakes. Fifty patients (24%) had tumour positive SLN. With a mean follow-up of 31.3 months, 29 tumour recurrences were observed, 19 (38%) in 50 SLN positive and 10 (6%) in 160 SLN negative patients. Strong predictive factors for early relapse (p < 0.0005) were SLN positivity and a high Breslow index.


CONCLUSIONS
SLN tumour positivity is an independent factor of high risk for early relapse with a higher power of discrimination than the Breslow index.
Willi
J-P
JP
Service de Médecine Nucléaire, University Hospital Geneva, Rue Mucheli-du-Crest 24, 1211 Genève 14, Switzerland. jean-pierre.willi@hcuge.ch
Matter
M
M
Buchegger
F
F
Antonescu
C
C
Guggisberg
D
D
Cerottini
J-P
JP
Krischer
J
J
Braun
R
R
Marie Kurt
A
A
Roche
B
B
Lemoine
R
R
Rimoldi
D
D
Lejeune
F J
FJ
Liénard
D
D
Bischof Delaloye
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012008:Recurrence; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis