TITLE:
The Role of Sentinel Lymph Node Biopsy in Thin Melanoma (Breslow Thickness ≤ 0.75 mm and 0.76 mm - 1.0 mm Respectively): Our Results and Review of the Literature
AUTHORS:
Georgios Kechagias, Aristea Marra, Athanasios Karonidis, Eugenia Kyriopoulos, Helen Gogas, Dimosthenis Tsoutsos
KEYWORDS:
Thin Melanoma, SLN, SLNB
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.3,
March
7,
2016
ABSTRACT: Introduction: The Sentinel Lymph Node Biopsy (SLNB) in melanoma is an
important tool of staging. The impact on overall survival still remains
unclear. The guidelines in regard to depth, taking in mind where SLNB staging
benefits do not outweigh the risks of the procedure, are constantly reviewed
and modified. Patients and Methods: From 2010 to 2015, 104 patients with thin
melanoma Stage IA with presence of adverse or high risk features and from IB
only TIb, N0, M0 (American Joint Committee on Cancer, AJCC Melanoma Staging and
Classification 7th Edition 2009) were included and divided into 2
groups: Group A: 68 patients with Breslow ≤ 0.75 mm and Group B: 36 patients
with Breslow 0.76 - 1.0 mm. Initially all patients underwent excision of the
primary site and subsequently wide local excision and SLNB. We analyzed the
histopathology reports of SLNB procedures in both groups. Results: There was no
positive SLN in group A (0%). 4 patients from group B had positive SLN (11.1%)
and underwent Completion Lymph Node Dissection (CLND). The total percentage of
positive SLNs from both groups was 3.8%. Conclusions: Our findings justify the
SLNB procedure in thin melanomas of 0.76 - 1.0 mm. In melanomas ≤ 0.75 mm, SLNB
should be considered on an individual basis when “high-risk features” are
present. More comparable studies should be evaluated in order to accurately
define the threshold value of Breslow thickness where SLNB is safely deemed
unnecessary.