Sentinel Lymph Node Biopsy in Thick Melanoma: A Single-Centre Retrospective Clinical Study
Abstract
Background: Sentinel lymph node biopsy is widely accepted in the staging of melanoma. The prognostic value of this technique seems to be greater in intermediate-thickness melanoma (1-4 mm) than in thick melanoma (>4 mm).
Objective: To assess the prognostic value of sentinel node status in patients with thick melanoma.
Patients and Methods: The disease-free survival and the overall survival were estimated using Kaplan-Meier curves and a Cox regression model in a sample of patients with thick melanoma.
Results: Forty-three patients were included (52.2% male) with a mean age of 63.9 years. Sentinel node biopsy was positive in 20 patients (46.5%). Mean follow-up was 40 months. Patients without sentinel node metastases had a 5-year disease-free survival rate significantly higher than those with positive sentinel node (63% versus 19%, p < 0.05). The 5-year overall survival rate was tendentiously lower in patients with positive sentinel node (52% versus 79%), lacking statistical significance.
Conclusion: The sentinel node status was not able to predict the overall survival in our series of thick melanomas, probably due to the high risk of hematic spread. However, sentinel lymph node biopsy provided important prognostic information, since the sentinel lymph node status influenced the disease-free survival.
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