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Sentinel lymph node biopsy for ocular adnexal melanoma
Margaret L Pfeiffer1,2, Omar K Ozgur1, Jeffrey N Myers3
1Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Acta Ophthalmologica
|October 25, 2016
Summary
Sentinel lymph node biopsy (SLNB) is a safe procedure for ocular adnexal melanoma, identifying nodal metastasis in about 20% of cases. Increased tumor thickness, mitotic figures, and ulceration predict positive SLN findings.
Area of Science:
- Ophthalmology
- Oncology
- Surgical Pathology
Background:
- Sentinel lymph node biopsy (SLNB) is a crucial staging procedure for various cancers.
- Previous reports have established SLNB's utility in conjunctival and eyelid melanoma.
- This study updates findings on SLNB and positive sentinel lymph node (SLN) predictors in these patients.
Purpose of the Study:
- To update findings on sentinel lymph node biopsy (SLNB) in ocular adnexal melanoma.
- To identify predictors of a positive SLN in patients with conjunctival or eyelid melanoma.
- To assess the safety and efficacy of SLNB in this patient population.
Main Methods:
- Retrospective review of ocular adnexal melanoma patients undergoing SLNB (2000-2015).
- Determination of positive and false-negative SLNB rates.
- Analysis of primary tumor features correlated with positive SLN and nodal recurrence rates.
Main Results:
- 51 patients included (31 conjunctival, 20 eyelid melanoma).
- 10 patients (approx. 20%) had positive SLNB findings.
- Positive SLN associated with greater tumor thickness, mitotic figures, and ulceration (p<0.05).
- Three false-negative events occurred; three patients experienced temporary nerve weakness.
Conclusions:
- SLNB is a safe and effective procedure for staging ocular adnexal melanoma.
- SLNB identifies nodal micrometastasis in approximately 20% of cases.
- Tumor thickness, mitotic rate, and ulceration are significant predictors of positive SLN.
