RECURRENCE OF MELANOMA FOLLOWING A NEGATIVE SENTINEL LYMPH NODE BIOPSY - A RETROSPECTIVE STUDY

  • Helena Toda-Brito Interna de Dermatologia e Venereologia/Resident, Dermatology and Venereology, Serviço de Dermatologia/ Dermatology Department, Hospital Distrital de Santarém, Portugal
  • Teresa Rodrigues Laboratório de Biomatemática, Faculdade de Medicina de Lisboa/Biomathematical Laboratory, Faculty of Medicine of Lisbon, Portugal
  • Ermelindo Tavares Assistente Hospitalar de Dermatologia e Venereologia/Consultant, Dermatology and Venereology, Serviço de Dermatologia/Dermatology Department, Hospital Distrital de Santarém, Portugal
  • Joana Parente Assistente Hospitalar de Dermatologia e Venereologia/Consultant, Dermatology and Venereology, Serviço de Dermatologia/Dermatology Department, Hospital Distrital de Santarém, Portugal
  • César Martins Assistente Hospitalar Graduado de Dermatologia e Venereologia/Graduated Consultant, Dermatology and Venereology, Serviço de Dermatologia/Dermatology Department, Hospital Distrital de Santarém, Portugal
  • Luís Ferreira Assistente Hospitalar Graduado de Cirurgia Geral/Graduated Consultant, General Surgery; Serviço de Cirurgia Geral/General Surgery Department, Hospital Distrital de Santarém, Portugal
Keywords: Melanoma, Neoplasm recurrence, local, Sentinel lymph node biopsy, Skin neoplasms

Abstract

Introduction: The sentinel lymph node biopsy is an important tool for staging patients with melanoma, allowing identification of occult regional lymph node involvement and avoidance of unnecessary lymphadenectomies.

Objective: To analyze the patterns of recurrence of melanoma in patients with a negative sentinel lymph node biopsy result and identify the clinical and pathological characteristics potentially predictive of recurrence after a negative sentinel lymph node biopsy.

Materials and methods: A retrospective study was conducted in patients with cutaneous melanoma who underwent sentinel lymph node biopsy in the Department of Dermatology, Santarém Hospital, between 2005 and 2011.

Results: 96 sentinel lymph node biopsy staged patients were evaluated. Of these, 29 patients had a positive sentinel lymph node biopsy result, 66 had a negative sentinel lymph node biopsy result and one patient had an inconclusive result. Among the 66 patients with a negative sentinel lymph node biopsy result, 11 (16.7 % of the negative results) had a recurrence of melanoma at a median of 21.7 months of follow-up (range, 8-51 months). Compared to the patients without recurrence, these patients had an older age at diagnosis (mean 71.8 vs 62.9 years; p=0.021), were predominantly of male sex (54.5% vs 29.1%; p=0,159), and had deeper primary lesions (median thickness 2.92 vs 1.80 mm; p=0.087) that were more likely to be ulcerated (63.6% vs 38.1%; p=0,177) and to have vascular/perineural invasion (40% vs 13%; p=0,207). Nodular melanoma was the most prevalent clinical variant in this group (54.5%), while in the group with recurrence prevailed the superficial spreading type (50.9%).

Conclusions: Overall, recurrence of melanoma after a negative sentinel lymph node biopsy result (16.7%) was similar to that in previously reported studies. We identified as possible predictors of recurrence, despite a negative sentinel lymph node biopsy result: older age at diagnosis, male sex, higher Breslow thickness, presence of ulceration, presence of vascular/perineural invasion, and nodular variant.

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How to Cite
Toda-Brito, H., Rodrigues, T., Tavares, E., Parente, J., Martins, C., & Ferreira, L. (1). RECURRENCE OF MELANOMA FOLLOWING A NEGATIVE SENTINEL LYMPH NODE BIOPSY - A RETROSPECTIVE STUDY. Journal of the Portuguese Society of Dermatology and Venereology, 73(2), 227-235. https://doi.org/10.29021/spdv.73.2.369
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Original Articles