Clinical significance of intra-nodal naevi in sentinel node biopsies for malignant melanoma.
BACKGROUND
Intra-nodal naevi (INN) identified during assessment of a sentinel lymph node for melanoma are not an uncommon finding. Little is known about their clinical significance. Patients with INN are treated as sentinel node biopsy (SNB) negative currently. Our aim was to assess the significance of INN in patients who undergo SNB for melanoma.


METHODS
353 melanoma patients who underwent a SNB between November 1999 and June 2012 were retrospectively analysed from a prospectively collected database. The patients were divided into SNB negative, INN, isolated tumour cells (ITC) and SNB positive groups. Outcome measures of nodal recurrence, distal recurrence and survival were used to assess the differences between the groups.


RESULTS
203 patients were SNB negative, 103 were positive of which 13 had ITC, 47 had INN (13%). Overall median follow up was 2.3 years (range 0.1-14.1 years). Our data demonstrated a statistically significant survival benefit for patients who had an INN compared to the SNB positive and ITC group. INN patients also had significantly better nodal and regional recurrence compared to SNB positive patients. There was no difference between INN and SNB negative patients.


CONCLUSIONS
We have clinically demonstrated that patients with INN on SNB can be adequately treated as SNB negative patients.
Department of Plastic Surgery, The Christie Hospital, 550 Wilmslow Road, Manchester, M20 4BX, UK.
O J
OJ
Smith
Department of Plastic Surgery, The Christie Hospital, 550 Wilmslow Road, Manchester, M20 4BX, UK.
J A J
JA
Coelho
Department of Plastic Surgery, The Christie Hospital, 550 Wilmslow Road, Manchester, M20 4BX, UK.
A E
AE
Trevatt
Department of Plastic Surgery, The Christie Hospital, 550 Wilmslow Road, Manchester, M20 4BX, UK. Electronic address: glross@gmail.com.
G L
GL
Ross
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008198:Lymph Nodes; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000473:pathology*; D009506:Nevus / Q000473:pathology*; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology*; D055815:Young Adult
Intra-nodal naevi; Isolated tumour cells; Melanoma; Metastatic melanoma; Sentinel node biopsy