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Dermal melanoma: A report on prognosis, outcomes, and the utility of sentinel lymph node biopsy
Author(s) -
Doepker Matthew P.,
Thompson Zachary J.,
Harb Jennifer N.,
Messina Jane L.,
Puleo Christopher A.,
Egan Kathleen M.,
Sarnaik Amod A.,
Gonzalez Ricardo J.,
Sondak Ver K.,
Zager Jonathan S.
Publication year - 2016
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24088
Subject(s) - medicine , sentinel lymph node , biopsy , melanoma , stage (stratigraphy) , sentinel node , surgery , radiology , cancer , paleontology , cancer research , biology , breast cancer
Historically dermal melanoma (DM) has been labeled as either stage IIIB (in‐transit) or stage IV (M1a) disease. We sought to investigate the natural history of DM and the utility and prognostic significance of sentinel lymph node biopsy (SLNB). Methods Patients with DM undergoing SLNB at a single center from 1998 to 2009 were identified. Results Eighty‐three patients met criteria, 10 (12%) patients had a positive SLNB. Of those, 5 (50%) recurred (all with distant disease). Twenty‐one (29%) of the 73 SLNB negative patients recurred and of those, 15 (71%) developed distant metastases, whereas 6 (29%) developed local or regional recurrence, including two false‐negative regional nodal recurrences. No in‐transit recurrences were recorded. Five‐year recurrence‐free and disease‐specific survival was significantly better for patients with a negative SLNB versus positive SLNB (56.8% vs. 22.2% P = 0.02, 81.1% vs. 61.0%, P = 0.05, respectively). Conclusion SLNB has prognostic significance for RFS and DSS, and should be utilized in the management of DM based on a >10% yield and low false‐negative rate. Our data demonstrate patients with DM do not recur in an in‐transit fashion, which along with the survival outcomes suggest the behavior of DM is consistent with primary cutaneous melanoma of similar thickness rather than an isolated in‐transit or distant dermal metastasis from a regressed cutaneous primary. J. Surg. Oncol. 2016;113:98–102 . © 2015 Wiley Periodicals, Inc.