Sentinel lymph node biopsy in patients with thin melanoma: occurrence of nodal metastases and its prognostic value.
We identified the proportion of positive sentinel lymph node biopsies (SNBs) in patients treated for thin melanoma (Breslow thickness <or= 1.0 mm). Breslow thickness is compared to the American Joint Committee of Cancer (AJCC) stage as a predictor for sentinel node involvement, and the prognostic value of the SNB in thin melanoma is analysed.Our prospective database of 248 patients, treated for melanoma between January 1994 and August 2007, was reviewed and completed. In 78 patients, SNB was performed for a thin melanoma. Overall, 23.8% of the SNBs were positive; in thin melanoma 6.4% were positive. All those nodal metastases were found in the group with a Breslow thickness of 0.76-1.0 mm, resulting in 12.8% of positive SNBs in this subgroup (X(2) p = 0.02). In AJCC stage 1a, 4.3% had a positive SNB, in AJCC stage 1b the SNB positive proportion was 9.4% (X(2) p = 0.38). Disease free survival in the node positive group was 100%. Breslow thickness only appears to be a practical tool in predicting lymph node involvement. SNB can be omitted in melanoma patients with a Breslow thickness <or= 0.75 mm. The prognostic value of SNB might be different in thin melanoma patients. Further research is warranted to asses the value of SNB in this subgroup of patients.
Vermeeren
Lenka
L
Department of Surgery, Orbis Medical Centre, 6162 BG Sittard-Geleen, The Netherlands. l.vermeeren@nki.nl
Van der Ent
Fred
F
Sastrowijoto
Prapto
P
Hulsewé
Karel
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*; D055815:Young Adult