Sentinel lymph node biopsy in thin melanoma patients

Hershko, Dan; Robb, Bruce W.; Lowy, Andrew M.; Ahmad, Syed A.; Ramadas, Go H.; Soldano, Debbie A.; Sussman, Jeffrey J.

doi:10.1002/jso.20415

Cited by 32 publications

(20 citation statements)

References 47 publications

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“…19 Other clinicians have reported their institutional results for SLNB in this group, confirming a consistently low incidence of occult nodal metastasis and a variability of tumor/patient characteristics that correlated with nodal status. [20][21][22] We recently reported our own results for SLNB in a large group of thin melanoma patients and confirmed the important prognostic significance of SN status in this patient group, in terms of both recurrent disease and melanoma-specific survival. 23 Thick melanoma patients have traditionally not been offered surgical staging of the regional nodal basin because their high risk for occult distant metastases was felt to be prohibitive and also more indicative of outcome than nodal status.…”

Section: -15supporting

confidence: 71%

The Current Role of Sentinel Lymph Node Biopsy in Breast, Melanoma, and Gastrointestinal Cancers

Wright¹,

Giuliano²

2008

Oncology &Amp; Hematology Review (US)

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Section: -15supporting

confidence: 71%

The Current Role of Sentinel Lymph Node Biopsy in Breast, Melanoma, and Gastrointestinal Cancers

Wright¹,

Giuliano²

2008

Oncology &Amp; Hematology Review (US)

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“…For example, factors reported to be predictive of SLN positivity include Breslow thickness, 13,23,25,26 Clark level, 18,19,23,26 vertical growth, 16 MR, 13,16,23 ulceration, 16 presence of regression, 27 absence of regression, 28 age 18 and male sex, 18 whereas some studies have identified no predictive parameters. 11,12,20 Multivariate analysis of predictors of SLN positivity in thin primary melanoma patients has only been carried out in 3 previous studies.…”

Section: Discussionmentioning

confidence: 95%

Sentinel Lymph Node Biopsy in Patients With Thin Primary Cutaneous Melanoma

Murali

Haydu²,

Quinn³

et al. 2012

Annals of Surgery

110

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There is a low but significant rate of SLN positivity in patients with primary melanomas 0.51 to 1.0 mm in thickness. Given its prognostic importance, SLNB should be considered in such patients, particularly if there is lymphatic permeation by melanoma at the primary tumor site. More frequent regional node field recurrences in patients with head/neck primary tumors may be a consequence of complex lymphatic drainage patterns in this region.

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“…Of studies which provided baseline demographic information on thin melanoma patients, 452 were female and 512 were male. 10, 11, 14, 21–28 The mean age was reported in 4 studies and ranged between 47.6 years to 53 years 23, 25, 26, 28 , and the reported median age ranged from 52.5 years to 54 years in 3 studies 10, 14, 24 .…”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of sentinel lymph node positivity in thin melanoma (≤1 mm)

Warycha

Zakrzewski

et al. 2008

Cancer

108

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Background Despite the lack of an established survival benefit of sentinel lymph node (SLN) biopsy, this technique has been increasingly applied in the staging of thin (≤1 mm) melanoma patients, without clear evidence to support this recommendation. We performed a meta-analysis to estimate the risk, potential predictors, and outcome of SLN positivity in this group of patients. Methods MEDLINE, EMBASE, and Cochrane databases were searched for rates of SLN positivity in patients with thin melanoma. The methodological quality of included studies was assessed using the MINORS criteria. Heterogeneity was assessed using Cochran’s Q-statistic, and publication bias was examined through funnel plot and Begg and Mazumdar’s method. Overall SLN positivity in thin melanoma patients was estimated using DerSimonial-Laird random effect method. Results 34 studies comprising 3,651 patients met inclusion criteria. The pooled SLN positivity rate was 5.6%. Significant heterogeneity among studies was detected (p=0.005). There was no statistical evidence of publication bias (p=0.21). 18 studies reported select clinical and histopathologic data limited to SLN positive patients (n=113). Among the tumors from these patients, 6.1% were ulcerated, 31.5% showed regression, and 47.5% were Clark’s level IV/V. Only 4 melanoma-related deaths were reported. Conclusion Relatively few patients with thin melanoma have a positive SLN. There are no clinical or histopathologic criteria which can reliably identify thin melanoma patients who might benefit from this intervention. Given the increasing diagnosis of thin melanoma, in addition to the cost and potential morbidity of this procedure, alternative strategies to identify patients at risk for nodal disease are needed.

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Sentinel lymph node biopsy in thin melanoma patients

Cited by 32 publications

References 47 publications

The Current Role of Sentinel Lymph Node Biopsy in Breast, Melanoma, and Gastrointestinal Cancers

The Current Role of Sentinel Lymph Node Biopsy in Breast, Melanoma, and Gastrointestinal Cancers

Sentinel Lymph Node Biopsy in Patients With Thin Primary Cutaneous Melanoma

Meta‐analysis of sentinel lymph node positivity in thin melanoma (≤1 mm)

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