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Prognostic usefulness of sentinel lymph node biopsy for patients who have clinically node negative, localized,
1Department of Dermatology, Rush University Medical Center, 1653 W Congress Pkwy, Annex Bldg, Ste 220, Chicago, IL 60612, USA. Arthur_Rhodes@Rush.edu
Objective:
To assess the prognostic value of sentinel lymph node biopsy status for patients with localized, clinically node negative, primary invasive cutaneous melanoma.
Design:
Predictive value of positive or negative sentinel lymph node biopsy (SLNB) results for melanoma-related death, using raw numbers from informative publications.
Setting And Participants:
Reports comprising 50 patients with cutaneous melanoma who had undergone SLNB, based on PubMed search (January 1, 1993, through June 3, 2010).
Main Outcome Measure:
Melanoma-related death.
Results:
For the 2 informative reports of patients with tumors of intermediate thickness (1-4 mm), risk of melanoma-related death ranged from 26.2% to 31.6% for node-positive cases and from 9.7% to 15.6% for node-negative cases. Based on 4 informative reports of patients with thin tumors (≤ 1 mm), risk of melanoma-related death ranged from 0% to 0.6% for both node-positive and node-negative cases. For the single informative report of patients with thick tumors (≥ 4 mm), risk of melanoma-related death was 32.5% for node-positive cases and 30.1% for node-negative cases. For 19 informative case series with any tumor thickness, risk of melanoma-related death ranged from 0% to 47.8% for node-positive cases and from 0% to 13.3% for node-negative cases.
Conclusion:
Prognostic information provided by SLNB status may be variably useful for patients who have tumors of intermediate thickness (1-4 mm) and not very useful for patients who have thin (≤ 1 mm) or thick (≥ 4 mm) tumors.
