title: Sentinel lymph node biopsy in melanoma: our 8-year clinical experience in a single French institute (2002-2009).
abstract: BACKGROUND
  Since the introduction of sentinel lymph node biopsy (SLNB), its use as a standard of care for patients with clinically node-negative cutaneous melanoma remains controversial. We wished to evaluate our experience of SLNB for melanoma.
  
  
  METHODS
  A single center observational cohort of 203 melanoma patients with a primary cutaneous melanoma (tumour thickness > 1 mm) and without clinical evidence of metastasis was investigated from 2002 to 2009. Head and neck melanoma were excluded. SLN was identified following preoperative lymphoscintigraphy and intraoperative gamma probe interrogation.
  
  
  RESULTS
  The SLN identification rate was 97%. The SLN was tumor positive in 44 patients (22%). Positive SLN was significantly associated with primary tumor thickness and microscopic ulceration. The median follow-up was 39.5 (5-97) months. Disease progression was significantly more frequent in SLN positive patients (32% vs 13%, p = 0.002). Five-year DFS and OS of the entire cohort were 79.6% and 84.6%, respectively, with a statistical significant difference between SLN positive (58.7% and 69.7%) and SLN negative (85% and 90.3%) patients (p = 0.0006 and p = 0.0096 respectively). Postoperative complications after SLNB were observed in 12% of patients.
  
  
  CONCLUSIONS
  Our data confirm previous studies and support the clinical usefulness of SLNB as a reliable and accurate staging method in patients with cutaneous melanoma. However, the benefit of additional CLND in patients with positive SLN remains to be demonstrated.
authors.affiliation: Department of Dermatology, Besançon University Hospital, Besançon, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Biver-Dalle
authors.forename: Eve
authors.initials: E
authors.lastname: Puzenat
authors.forename: Marc
authors.initials: M
authors.lastname: Puyraveau
authors.forename: Delphine
authors.initials: D
authors.lastname: Delroeux
authors.forename: Hatem
authors.initials: H
authors.lastname: Boulahdour
authors.forename: Frances
authors.initials: F
authors.lastname: Sheppard
authors.forename: Fabien
authors.initials: F
authors.lastname: Pelletier
authors.forename: Philippe
authors.initials: P
authors.lastname: Humbert
authors.forename: François
authors.initials: F
authors.lastname: Aubin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*; D055815:Young Adult