Sentinel Node Biopsy is Indicated for Thin Melanomas ≥0.76 mm

• Published in: Annals of surgical oncology 2012-10, Vol.19 (11), p.3335-3342
• Main Authors: Han, Dale, Yu, Daohai, Zhao, Xiuhua, Marzban, Suroosh S., Messina, Jane L., Gonzalez, Ricardo J., Wayne Cruse, C., Sarnaik, Amod A., Puleo, Christopher, Sondak, Vernon K., Zager, Jonathan S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Confidence Intervals; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Logistic Models; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Melanoma - secondary; Melanoma - surgery; Melanomas; Middle Aged; Neoplasm Staging; Odds Ratio; Oncology; Predictive Value of Tests; Retrospective Studies; Sentinel Lymph Node Biopsy; Skin Neoplasms - pathology; Skin Neoplasms - surgery; Surgery; Surgical Oncology; Young Adult
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-012-2469-1

Background A consensus for which patients with thin melanomas (≤1 mm) should undergo sentinel lymph node biopsy (SLNB) is not established. We describe a large single institution experience with SLNB for thin melanomas to determine factors predictive of nodal metastases. Methods Retrospective review from 2005 to 2010 identified 271 patients with thin melanomas who underwent SLNB, along with 13 additional patients not treated with SLNB who developed a nodal recurrence as first site of recurrence. Clinicopathologic characteristics were correlated with nodal status and outcome. Results Median age was 55 years, and 53 % of patients were male. Median Breslow thickness was 0.85 mm. Overall, a positive sentinel lymph node (SLN) was found in 22 (8.1 %) of 271 cases; 8.4 % of melanomas ≥0.76 mm were SLN positive with 5 % of T1a melanomas ≥0.76 mm and 13 % of T1b melanomas ≥0.76 mm having SLN metastases. Only two of 33 highly selected patients with melanomas