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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.
Journal of Surgical Oncology
|February 24, 2006
Summary
Sentinel lymph node biopsy (SNB) can detect occult nodal disease in thin melanoma patients. While PCR positivity was high, routine histology identified positive nodes in 8% of patients, warranting discussion of SNB for selected cases.
Area of Science:
- Dermatology
- Surgical Oncology
- Pathology
Background:
- Thin melanoma (
- Identifying high-risk subgroups for nodal disease is crucial for patient management.
Purpose of the Study:
- To determine the incidence of positive sentinel lymph nodes in thin melanoma patients.
- To identify patient subgroups with an increased risk of occult nodal disease.
Main Methods:
- Retrospective review of 107 thin melanoma patients treated between 1997 and 2003.
- Sentinel lymph nodes (SLNs) analyzed via routine histology, step sectioning, immunohistochemistry, and RT-PCR for melanoma markers.
Main Results:
- Sentinel lymph node biopsy (SNB) was performed in 64 patients.
- Routine histology detected positive SLNs in 8% of patients; RT-PCR detected positivity in 58%.
- Younger age was the only significant prognostic factor for node positivity in mapped patients.
Conclusions:
- Sentinel lymph node biopsy (SNB) should be considered for selected thin melanoma patients to detect microscopic disease due to its low morbidity.
- RT-PCR positivity in this study was too common to be clinically significant for thin melanoma and requires further investigation.