Analysis of disease free survival in cutaneous melanoma patients with sentinel lymph node biopsy

Abstract

Introduction: Skin melanoma is estimated for 2% of malignant neoplasms occurring in humans. It is characterized by a high level of malignancy and low sensitivity to cytostatic drugs. The incidence of skin melanoma increases in Poland. Lymphatic system is the most common route of dissemination of this neoplasm. The appearance of a sentinel node biopsy technique has made it possible to identify patients with a regionally advanced disease. It is a minimally invasive method with a small percentage of complications. Aim: Analysis of disease free survival (DFS) in cutaneous melanoma patients with sentinel lymph node biopsy. Material and methods: The analysis included 222 patients with cutaneous melanoma treated in the Department of Oncological Surgery in 2010–2015, who underwent a sentinel node biopsy. The study group consisted of 136 women and 86 men, the average age of patients was 59 years. Patients were qualified for sentinel node biopsy based on clinical evaluation and ultrasound of regional lymph nodes. The average follow-up was 25.1 months. About 2 hours before surgery, patients received the radioisotope, then lymphoscintigraphy SPECT was performed. Additionally, they got the Patent Blue dye in the operating room. Results: The sentinel node was identified in 217 patients (98%), and the average sentinel sentinel nodes were 2.25. 27 patients (12%) had the metastasis in sentinel nodes. In this group, the duration of asymptomatic survival was significantly shorter. Sentinel node status and age of the patient were independent factors affecting the prognosis of disease free survival. Conclusions: Sentinel node biopsy is a precise method to identify patients with skin melanoma who have metastasis to regional lymph nodes and the most important prognostic factor.