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Sentinel lymph node biopsy in thin melanoma patients
Dan D Hershko1, Bruce W Robb, Andrew M Lowy
1Department of Surgery, A. Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.
Background:
We sought to determine the incidence of positive sentinel lymph nodes in thin melanoma (
Methods:
Patients with
Results:
Sixty-four of 107 thin melanoma patients underwent sentinel node biopsy (SNB). Mapped patients were more likely to have Clark >or= III and thicker lesions (mean 0.77 mm vs. 0.47 mm), but were not different in regards to age, sex, or lesion location. Eight percent and 58% of sentinel nodes were positive by routine histology and RT-PCR, respectively. Among mapped patients, younger age was the only significant prognostic factor for node positivity. With a median follow-up of 18 months among all patients, one regional recurrence (at 2 years) has been identified.
Conclusions:
Given the low morbidity of sentinel lymph node biopsy, this procedure should be discussed with selected thin melanoma patients to detect microscopic disease, however PCR positivity by our methods is too commonly seen to be clinically significant in thin melanoma patients and requires additional study.
