Complete lymph node dissection or observation in melanoma patients with multiple positive sentinel lymph nodes: A single‐center retrospective analysis

Abstract

Although the role of sentinel lymph node biopsy (SLNB) as a prognostic factor is well established, its consequences for therapy are controversial. The aim of this study was to analyze if complete lymph node dissection (CLND) in patients with more than one positive sentinel lymph node (SLN) significantly improves melanoma-specific survival (MSS) and progression-free survival (PFS). Medical records of patients who underwent SLNB between 2001 and 2016 at the University Hospital of Cologne were reviewed, and patients with positive SLN were identified. Patient and tumor characteristics, patterns of recurrence, progression-free and melanoma-specific survival were analyzed. Seventy-eight patients with multiple positive and 197 patients with one positive SLN were included in this study. Patients with multiple positive SLN had significantly more positive non-SLN compared with patients with only one positive SLN (26.9% vs 8.6%, P = 0.01). However, in the subgroup of patients with multiple positive SLN, CLND did not significantly improve MSS (mean MSS 95 vs 75 months, P = 0.5) and PFS (mean PFS 59 vs 68 months P = 0.167). CLND did not result in a significant improvement in PFS and MSS in patients with multiple positive SLN.

Predicting risk for seroma development after axillary or inguinal sentinel lymph node biopsy in melanoma patients

“…SLNB is a routine procedure in the staging of patients with cutaneous melanoma used to select patients for radical lymph node dissection as well as guide decision on adjuvant therapy. Since performing SLNB has mainly a prognostic value, it must be balanced against the potential for morbidity from the procedure. Male sex, inguinal localization, and smoking were identified as independent risk factors for the development of seroma.…”

Risk factors for recurrence of malignant melanoma in patients with negative sentinel lymph node biopsy

“…Risk factors for recurrence of malignant melanoma in patients with negative sentinel lymph node biopsy Dear Editors, Sentinel lymph node biopsy (SLNB) is a standard procedure in the staging of cutaneous malignant melanoma, and guides decisions regarding adjuvant therapy [1,2]. Sentinel lymph node biopsy is generally associated with few complications [3,4] and was initially implemented to avoid the increased morbidity associated with radical dissection, which, in the current era of adjuvant programmed cell death protein 1 inhibitor (PD-1-inhibitor) and targeted therapies is performed mostly for macrometastasis [5].…”

“…Patients with a follow-up of less than six months were excluded. The SLNB procedure, indications for SLNB as well as histological examination of SLNs were described previously [2,3]. Comparisons between the clinicopathologic characteristics of the patient groups were performed using Student's t-test and chi-square analysis.…”

Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis

“…Primary search strategy produced 744 records, after which qualification process followed, as well as elimination of duplicates, resulting in 425 articles, of which 22 datasets met the criteria for full-text review [2,3,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Finally, seven papers were included in the meta-analysis (Table 1).…”