title: Sentinel lymph node biopsy for ocular adnexal melanoma.
abstract: BACKGROUND
  We sought to update our prior report of findings on sentinel lymph node biopsy (SLNB) and predictors of a positive SLN in patients with conjunctival or eyelid melanoma.
  
  
  METHODS
  We reviewed the records of all patients with ocular adnexal melanoma who underwent SLNB at one institution during 2000-2015. We determined rates of positive and false-negative findings on SLNB, primary tumour features correlated with positive findings and rate of nodal recurrence (false-negative event) after negative findings.
  
  
  RESULTS
  The study included 51 patients, 31 with conjunctival and 20 with eyelid melanoma. These patients include 30 patients who underwent SLNB during 2000-2008, described in our previous report, and 21 additional patients who underwent SLNB during 2008-2015. There were 30 women and 21 men with median age at SLNB of 62 years (range, 24-83). The nodal basins most commonly sampled were intraparotid (27 patients) and level II (14 patients). Ten patients had positive SLNB findings. Compared to tumours with negative findings, tumours with positive findings had greater median thickness (3.5 mm versus 2.2 mm, p = 0.04), greater median number of mitotic figures (6 versus 2, p = 0.03) and greater incidence of ulceration (80% versus 26%, p = 0.003). Perineural and vascular invasion were not significantly associated with positive findings. There were three false-negative events. Three patients (6%) had temporary marginal mandibular weakness which resolved spontaneously.
  
  
  CONCLUSIONS
  SLNB in patients with ocular adnexal melanoma is safe and identifies nodal micrometastasis in approximately 20% of cases. Histologic features associated with a positive SLN included greater tumour thickness, greater number of mitotic figures and ulceration.
authors: Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.|Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas, USA.
authors: Margaret L
authors: ML
authors: Pfeiffer
authors: Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Omar K
authors: OK
authors: Ozgur
authors: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Jeffrey N
authors: JN
authors: Myers
authors: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Andrew
authors: A
authors: Peng
authors: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Jing
authors: J
authors: Ning
authors: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Mark E
authors: ME
authors: Zafereo
authors: Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Sudip
authors: S
authors: Thakar
authors: Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Bradley
authors: B
authors: Thuro
authors: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Victor G
authors: VG
authors: Prieto
authors: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Merrick I
authors: MI
authors: Ross
authors: Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Bita
authors: B
authors: Esmaeli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003230:Conjunctival Neoplasms / Q000473:pathology*; D005142:Eyelid Neoplasms / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D055815:Young Adult
keywords: biopsy; melanoma; ocular adnexa; sentinel lymph node