title: The outcome of patients with melanoma is not associated with the time point of lymphatic mapping with respect to excisional biopsy of the primary tumor.
abstract: BACKGROUND
  Sentinel lymph node biopsy (SLNB) has become the standard care for melanoma and is an important diagnostic procedure. It has been doubted whether lymphoscintigraphy detects the correct sentinel lymph node (SLN) when excision of the tumor and SLNB are not performed at the same time. This would imply that this sequential approach may have an increased risk of undetected micrometastases resulting in a worse outcome.
  
  
  OBJECTIVE
  The purpose of the present study was to compare the outcome of melanoma patients having received excision of the tumor and SLNB either at the same time or consecutively.
  
  
  METHODS
  A total of 854 patients with cutaneous melanoma were enrolled in this retrospective study between September 1996 and November 2007. Disease-free (DFS) and overall survivals (OS) were estimated using the Kaplan-Meier product limit method and were analyzed by the log rank test.
  
  
  RESULTS
  No statistically significant difference was found regarding DFS, progression rates and OS in patients with primary tumor excision and SLNB at the same time compared with patients with excisional biopsy of primary tumor and SLNB at different times.
  
  
  CONCLUSIONS
  These data suggest that excisional biopsy of the primary tumor does not prevent the correct SLN mapping in melanoma patients.
authors.affiliation: Department of Dermatology and Allergology, Ludwig Maximilian University of Munich, Frauenlobstrasse 9-11, Munich, Germany.
authors.forename: Katharina J
authors.initials: KJ
authors.lastname: Gauwerky
authors.forename: Christian
authors.initials: C
authors.lastname: Kunte
authors.forename: Till
authors.initials: T
authors.lastname: Geimer
authors.forename: Jens
authors.initials: J
authors.lastname: Baumert
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Flaig
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.forename: Monika-Hildegard
authors.initials: MH
authors.lastname: Schmid-Wendtner
authors.forename: Carola
authors.initials: C
authors.lastname: Berking
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult