Sentinel lymph node biopsy for 102 patients with primary cutaneous melanoma at a single Japanese institute

Abstract

Sentinel lymph node biopsy (SLNB) is a widely accepted standard procedure for patients with clinically localized melanoma. Melanoma prevalence and Clark's subtype differ between Asians and Caucasians. Here, we evaluated our experience on SLNB for cutaneous melanoma in a Japanese population. SLNB was performed for patients with melanoma between July 2000 and June 2014. We retrospectively analyzed 102 patients regarding association of clinicopathological features with sentinel lymph node (SLN) status, melanoma‐specific survival (MSS) and disease‐free survival (DFS). A positive SLN was significantly associated with primary Breslow thickness. Compared with 43 patients with negative SLN, 59 patients with positive SLN had significantly shorter MSS (5‐year survival rate, 94.3% vs 63.2%; P = 0.0002) and DFS (5‐year survival rate, 92.7% vs 63.4%; P = 0.0004). According to our subgroup analyses, nine patients with positive non‐SLN had significantly shorter MSS compared with 32 patients with negative non‐SLN (5‐year survival rate, 32.4% vs 68.5%; P = 0.0273). The survival of 51 Japanese patients with acral lentiginous melanoma (ALM) was not inferior to the survival of patients with other Clark's subtype. Breslow thickness is an important factor for both MSS and DFS, and the status of SLN is the most predictive prognostic factor in Japanese patients with clinically localized melanomas, as in case of Caucasians. Features of ALM may be different between Asians and Caucasians.

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

“…SLN harvesting rate was similar to other Asian studies. 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.…”

“…[11][12] Unlike superficial spreading melanoma on the trunk, which is capable of metastasizing to multiple regional lymph nodes, acral melanoma has a limited pathway of regional lymph node metastases, for example, the right groin area from melanoma on the Previous Japanese studies, which include not only AM but also various subtypes of melanoma, showed that SLN metastasis is an impor-tant risk factor correlated with survival rates. 4,[6][7][8] It was also observed in Taiwanese and Chinese studies that SLN status is a crucial factor for survival of cutaneous melanoma (Table 4). [11][12][13] These studies consistently revealed that SLN metastasis is a significant predictive prognos- tic factor for survivals, especially in DFS.…”

“…Previous Japanese studies, which include not only AM but also various subtypes of melanoma, showed that SLN metastasis is an important risk factor correlated with survival rates 4,6–8 . It was also observed in Taiwanese and Chinese studies that SLN status is a crucial factor for survival of cutaneous melanoma (Table 4).…”

“…However, a series of SLNB reports from western countries have included date indicating a high proportion of superficial spreading melanomas on the trunk and extremities whereas much lower proportion on the acral location. Because cutaneous melanoma in East Asian countries, such as Korea, China, Taiwan and Japan, includes acral melanoma (AM) as the most common primary site, there is a need for additional SLNB data of the cohorts with AM 3–13 . Therefore we report long‐term clinical data of 107 Korean AM patients with SLNB from a tertiary referral center hospital.…”

“…Because cutaneous melanoma in East Asian countries, such as Korea, China, Taiwan and Japan, includes acral melanoma (AM) as the most common primary site, there is a need for additional SLNB data of the cohorts with AM. [3][4][5][6][7][8][9][10][11][12][13] Therefore we report long-term clinical data of 107 Korean AM patients with SLNB from a tertiary referral center hospital. We also performed this study in order to compare other Asian reports on SLNB in terms of feasibility, safety and survival issues.…”