Abstract
Background
The authors updated their experience with sentinel lymph node (SLN) biopsy of clinically
node negative (N0) melanoma to clarify indications, predictive factors, and outcomes.
Methods
A review of patients from the authors' institution's prospective database (n = 397)
was performed; survival statistics were obtained from the institutional tumor registry.
Results
The SLN-positive (SLN+) rate was 16% (47 of 282) for lesions >1 mm thick; only 2 of
105 T1 lesions were SLN+. Thickness >2 mm, upper extremity primary, and ulceration
predicted SLN+ status. Most SLN+ patients underwent completion node dissection; 12%
had additional positive nodes. The false-negative SLN biopsy rate was 4.0%; the majority
involved lower extremity and head and neck primaries. The overall complication rate
was 26%; all were minor and resolved within 6 months. Overall 5-year survival rates
were 73% and 92% for SLN+ and SLN-negative patients, respectively. SLN status was
the most significant predictor of survival.
Conclusions
SLN status, the most important determinant of outcome for clinically N0 melanoma,
correlated with T stage, ulceration, and site. Staging of T1 lesions had low yield.
A minority of completion node dissections yielded additional positive nodes.
Keywords
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Article info
Publication history
Received in revised form:
January 7,
2010
Received:
November 17,
2009
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
