Prognostic role of sentinel lymph node biopsy for patients with cutaneous melanoma: A retrospective study of surveillance, epidemiology, and end-result population-based data

Abstract

Sentinel lymph node biopsy (SLNB) is a sensitive operation for finding micro-metastasis in patients with cutaneous melanoma without evidence of clinically positive lymph node findings. However, until now, no clinical trials or retrospective studies with large samples have been performed to investigate the clinical role of SLNB for cutaneous melanoma patients. In this study, we used the data of cutaneous melanoma from the Surveillance, Epidemiology, and End Results (SEER) database to compare overall survival (OS) and melanoma-specific survival (MSS) outcomes with clinical lymph node and SLN status. In total, 56,285 eligible patients were identified in this study. Cutaneous melanoma patients with clinically-positive lymph nodes had significantly shorter OS (46.1% vs 78.6%, p = 0.000) and MSS (55.8% vs 90.5, p = 0.000) compared with clinically-negative lymph node patients. Patients who underwent SLNB had significantly longer 5-year rates for OS (84.3% vs 70.1, p = 0.000) and MSS (91.5% vs 90.3, p = 0.000) compared with patients who did not undergo SLNB (lymph node observation). Patients with a negative SLNB had a significantly longer 5-year rate for OS (86.5% vs 68.1% vs 46.1, p = 0.000) and MSS (93.7% vs 75.1% 55.8%, p = 0.000) than patients who were SLNB-positive or had clinically-positive lymph nodes. This present study showed that the status of SLN is a valuable prognostic factor in patients with Breslow thickness greater than 1 mm in clinically-negative lymph node cutaneous melanoma.

Does sentinel lymph node status have prognostic significance in patients with acral lentiginous melanoma?

“…Our study is consistent in that the median thickness was relatively high at 2 mm, which is greater than the median thickness of 1 mm for all newly diagnosed cutaneous melanomas . The overall positive SLN rate for cutaneous melanoma in the SEER database is approximately 9% to 12%, with a median thickness of 1.5 mm; however, the positive SLN rate for ALM is generally reported to be higher in the literature, ranging from 24% to 40% .…”

Identification of risk in cutaneous melanoma patients: Prognostic and predictive markers

“…Reflecting the increased incidence of node‐negative patients in this study population, nearly twice as many patients with intermediate‐thickness melanomas and node‐negative disease died compared with those having node‐positive disease (98 of 784 versus 50 of 152). This appears to mirror findings in the general population and suggests that a negative SLNBx is insufficient to exclude a risk of melanoma‐specific mortality in patients with early stage melanoma …”

Markers Usefulness in the Melanic Metastatic Cellular Epitops Identification in the Sentinel Lymph Node

“…The incidence of MMC increased in the last decades, especially because of a more intense exposure to the ultraviolet B radiation (UVR-B), particularly among the white population [2,3]. MMC is also considered a form of aggressive skin cancer [4,5]. Although some therapeutic advances were made, the survival rate for people with MMS for a period of 5 years is less than 5% and median survival ranges from 6-8 months.…”

“…Most of the pathologists agree that for the pure desmoplastic melanoma is not recommended the SLN [20,21]. SLN status is considered an important prognostic factor in patients with Breslow thickness > 1 mm in clinicalnegative MMC [4]. For patients recently diagnosed with melanoma, in the case of cutaneous melanoma with intermediate thickness, having a thickness between 1-4 mm Breslow, the biopsy of the sentinel node is considered appropriate.…”