Five-year follow-up of 16 melanoma patients with a Starz I-involved sentinel node in whom completion lymph node dissection was omitted

Abstract

The aim of the study was to determine the incidence of lymph node recurrence in 16 melanoma patients with a minimal metastasis (Starz level I) in a sentinel node in whom a completion lymph node dissection was omitted. A secondary aim was to examine whether other melanoma-related recurrences developed. Sixteen melanoma patients with an SI-involved sentinel node, who did not undergo completion lymph node dissection, were followed for a median of 66 months. Lymph node recurrences did not occur. One of the 16 patients developed a local recurrence and another developed satellite metastases. None of the 16 patients with an SI-positive sentinel node developed a nodal recurrence, which suggests that the risk of refraining from node dissection in such patients is small. This option could be considered and discussed with the patient in terms of the risk of nonsentinel node involvement and the unsolved problem of unknown overall survival advantage.

SLN melanoma micrometastasis predictivity of nodal status: a long term retrospective study

“…Considering that we recorded three dead patients among the S1 subgroup in absence of NSLN involvement, our future study will aim to select important biomarkers that, in combination with S-classification, could help to select a S1 subgroup presenting major risk of disease progression. Interestingly, while this research was in progress, Veenstra et al, reported a positive 5-years experience for 16 melanoma patients classified as Starz level 1 that did not undergo completion lymphatic node dissection [33]. Although further investigations are needed, on larger and multicentric studies, we think that our observations can contribute to suggest the way to find a clinically reliable technique (i.e.…”

“…On these bases some Authors suggested the possibility to avoid the CLND to a subgroup of selected patients [30-34]. Already in few centres, patients with SLN tumour deposits <0.1mm in maximal dimension can choose if undergo CLND or clinical nodal follow-up [16,18,33-38]. In our report, using univariate analysis, we confirmed the prognostic relevance of Starz classification suggesting that patients classified as S1 could safely spare to the CLND.…”