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Sentinel node biopsy (SNB) for melanoma recurrence or metastasis is infrequently performed but provides valuable prognostic information. Positive sentinel nodes indicate significantly worse survival, supporting SNB consideration in these cases.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Dermatology

Background:

  • Sentinel node biopsy (SNB) is not standard for melanoma with local recurrence (LR) or in-transit metastasis (ITM).
  • Limited data exist on the utility and outcomes of SNB in these specific patient groups.

Purpose of the Study:

  • To evaluate the technique, findings, and prognostic significance of SNB in melanoma patients with LR or ITM.
  • To describe patient outcomes following SNB for recurrent or metastatic melanoma.

Main Methods:

  • Prospective data collection from 1992-2015 at Melanoma Institute Australia.
  • Analysis of patient and tumor characteristics, lymphoscintigraphy, SNB results, and follow-up for 128 patients with LR or ITM undergoing SNB.

Main Results:

  • SNB was performed in 1.6% of eligible patients (128/7999), primarily for LR (6%) and ITM (1-15%).
  • The sentinel node identification rate was 100%, with 13% of SNs positive for metastasis.
  • SN-positive patients had significantly worse 5-year overall survival (54%) compared to SN-negative patients (81%), despite a 27% false-negative rate.

Conclusions:

  • SNB for melanoma LR or ITM is infrequently utilized but identifies metastasis in 13% of cases.
  • Positive sentinel nodes are associated with poorer overall survival, highlighting prognostic relevance.
  • Despite a notable false-negative rate, SNB provides crucial staging and prognostic data, warranting consideration for these patients.