Sentinel Lymph Node Biopsy vs. Observation in Thin Melanoma: A Multicenter Propensity Score Matching Study.

Area of Science:

• Oncology
• Dermatology
• Surgical Pathology

Background:

• The clinical utility of sentinel lymph node biopsy (SLNB) in thin melanomas (≤1 mm) is debated.
• Accurate prognostic indicators are crucial for managing thin melanoma cases.

Purpose of the Study:

• To evaluate the impact of SLNB on the survival outcomes of patients with thin melanomas.
• To determine if SLNB influences melanoma-specific survival (MSS), disease-free survival (DFS), or overall survival (OS).

Main Methods:

• A multicenter retrospective observational study involving 1438 matched patients.
• Propensity score matching was used to compare SLNB versus observation groups.
• Multivariate Cox regression analysis identified predictors of MSS.

Main Results:

• No significant difference in MSS, DFS, or OS was observed between the SLNB and observation groups.
• Age, tumor thickness, ulceration, and interferon treatment were significant predictors of MSS.
• A substantial survival disparity exists between SLN-positive and SLN-negative patients.

Conclusions:

• SLNB does not enhance survival rates for thin melanoma.
• SLNB serves as a valuable prognostic tool, differentiating patient outcomes based on lymph node status.
• Discussing SLNB as a prognostic option with thin melanoma patients is recommended.