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Updated: Jan 30, 2026
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Guidance of sentinel lymph node biopsy decisions in patients with T1-T2 melanoma using gene expression profiling
John T Vetto1, Eddy C Hsueh2, Brian R Gastman3
1Division of Surgical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA.
Aim:
Can gene expression profiling be used to identify patients with T1-T2 melanoma at low risk for sentinel lymph node (SLN) positivity?
Patients & Methods:
Bioinformatics modeling determined a population in which a 31-gene expression profile test predicted <5% SLN positivity. Multicenter, prospectively-tested (n = 1421) and retrospective (n = 690) cohorts were used for validation and outcomes, respectively.
Results:
Patients 55-64 years and ≥65 years with a class 1A (low-risk) profile had SLN positivity rates of 4.9% and 1.6%. Class 2B (high-risk) patients had SLN positivity rates of 30.8% and 11.9%. Melanoma-specific survival was 99.3% for patients ≥55 years with class 1A, T1-T2 tumors and 55.0% for class 2B, SLN-positive, T1-T2 tumors.
Conclusion:
The 31-gene expression profile test identifies patients who could potentially avoid SLN biopsy.
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