Sentinel node biopsy in cutaneous melanoma patients — early results

Abstract

Introduction. Surgery is the main treatment option for skin melanoma and the treatment results depend on stage. Most melanomas diagnosed in Poland are > pT1a and therefore sentinel node biopsy (SNB) is needed for accurate allows for accurate regional (nodal) staging. The aim of this work was to assess early treatment results in skin melanomapatients undergoing SNB.

Material and methods. From 2010 to 2012 in the Department of Surgical Oncology, Cancer Center in Kraków,115 skin melanoma patients underwent SNB (72 females and 43 males). Selected parameters potentially influencing survival were analyzed.

Results. In 15 (13%) patients SN was positive. In patients with positive SN melanomas were thicker compared to SN negative patients (5.16 versus 3.87 mm, p = 0.08). In 23 patients the disease relapsed: distant metastases (n = 17) or locoregional recurrence (n = 6). In the group with positive SN, recurrence was noted in 8 cases (53%); in the group with negative SN, recurrence was seen in 15 patients (15%). Recurrent patients were characterised by thicker melanomas (7.1 versus 3.53 mm, p = 0.03). No evidence of disease survival (Kaplan-Meier) curves were significantly separated for positive and negative SN groups. Cox analysis was used for prognostic parameters. SN status and mitotic index were shown to independently influence survival time with no evidence of disease (p = 0.001).

Conclusions. SNB effectively identifies melanoma patients with microscopic regional node metastases. Melanoma thickness (Breslow) significantly influences the risk for nodal metastases. Presence of nodal metastasis in SN and high mitotic activity significantly increased the risk of relapse.