Long-Term Survival Analysis and Clinical Follow-Up in Acral Lentiginous Malignant Melanoma Undergoing Sentinel Lymph Node Biopsy in Korean Patients

Abstract

BackgroundIn cutaneous malignant melanoma (MM) with clinically uninvolved regional lymph nodes, sentinel lymph node (SLN) status is the most powerful indicator of both overall survival (OS) and disease-free survival (DFS). However, no studies on the long-term survival and clinical follow-up of Korean patients with acral lentiginous MM (ALM) undergoing SLN biopsy (SLNB) have been published.ObjectiveThe purpose of this study was to investigate the clinical prognosis and long-term survival of Korean patients with ALM according to SLN status.MethodsThirty-four ALM patients undergoing SLNB were included in this study. We evaluated clinical and histopathological follow-up data such as the stage of disease, treatment, recurrence, and metastasis, and analyzed OS and DFS according to SLN status.ResultsThe median follow-up time was 60.5 months (range 3~127 months). Positive SLNs were noted in 14 patients (41.2%). Patients with negative SLNs had better OS and DFS than those with positive SLNs (p<0.05). Increased Breslow thickness was associated with short OS and DFS (p<0.05), and female patients showed better DFS than male patients (p<0.05).ConclusionTo our knowledge, this is the first study on the long-term survival and clinical follow-up of patients undergoing SLNB for ALM in Korea. Our findings show that SLN status is an important prognostic factor for predicting OS and DFS.

Sentinel lymph node biopsy in acral melanoma: A Korean single‐center experience with 107 patients (2006–2018)

“…Furthermore, SLN positivity rate of this study was 20.6% (22/107), so SLN positivity rate was consistent with other Asian studies ranging 11.9–41.8% 4–13 . Interestingly, it was relatively low compared with the result of another Korean study which revealed 41.2%, 16 a retrospective analysis based on single‐center as ours, but had smaller sample size of only 34 patients. Among 22 patients who showed metastatic SLN from this study, immediate CLND was performed in 18 (81.8%) patients.…”

Efficacy and clinical significance of omitting blue dye injection during sentinel lymph node biopsy before Mohs micrographic surgery for malignant melanoma of the lower extremities

“…The omission of blue dye injection can avoid both skin complications and rare but dangerous anaphylactic reactions; it may also enable SLNB under local instead of general anaesthesia, being safer and reducing time and costs . Accordingly, omitting blue dye injection has become increasingly common in recent clinical practice, and there have been several reports on the value of omitting blue dye injection during SLNB in patients with other malignancies such as breast or penile cancer …”

“…The omission of blue dye injection can avoid both skin complications and rare but dangerous anaphylactic reactions; it may also enable SLNB under local instead of general anaesthesia, being safer and reducing time and costs. 27 Accordingly, omitting blue dye injection has become increasingly common in recent clinical practice, 6,7 and there have been several reports on the value of omitting blue dye injection during SLNB in patients with other malignancies such as breast or penile cancer. 28,29 The cohort of the present study can be considered representative of patients undergoing SLNB for melanoma in Asia, as the demographic distributions, tumour depths, Breslow thicknesses and tumour locations were consistent with data from previous studies in Korea and other Asian countries.…”

A Case of Subungual Melanoma In Situ in an 18-Year-Old Girl Presented with Total Melanonychia

“…In 2015, Cooper et al 4 reviewed the English-language literature and identified only 10 cases of pediatric melanonychia striata that were histopathologically confirmed to be melanoma in situ . SUM is generally associated with poor prognosis, as most patients are diagnosed with advanced disease and early metastases are common 5 . Although invasive SUM is inevitably treated by partial or complete amputation of the affected digit according to the tumor thickness, SUM in situ can be treated by conservative excision of the nail apparatus.…”

“…Although invasive SUM is inevitably treated by partial or complete amputation of the affected digit according to the tumor thickness, SUM in situ can be treated by conservative excision of the nail apparatus. As even partial loss of thumb causes significant disability, early diagnosis leads to a better functional outcome 5 . Therefore, we suggest in the event that there are clinical findings indicative of SUM, even if the patient is of a young age, pathological examination is recommended for early diagnosis.…”