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Positive Sentinel Node Biopsy in Melanoma Associated With Increased Risk of Recurrence: Presented at AAD By Perrie Susman MIAMI BEACH, Fla -- March 12, 2010 -- Positive sentinel node biopsy findings in patients with melanoma appeared to indicate a high risk of recurrence of the cutaneous cancer, researchers said here at the 68th Annual Meeting of the American Academy of Dermatology (AAD). In scrutinising the 11-year institution history of performing sentinel node biopsies, researchers determined that 39.9% of the 43 patients who had a recurrence also had a positive sentinel node biopsy. “Of 417 patients with negative sentinel lymph node biopsy, about 7%, or 29 patients, developed recurrence versus 14 of 55 patients -- about 14.5% -- with positive sentinel node biopsy [P = .03],” said Suzanne Berkman, MD, Melanoma Center at the Washington Cancer Institute, Washington, DC. “The results from our institution confirm the importance of sentinel lymph node biopsy in staging and prognosis in patients with cutaneous melanoma,” she said during her poster presentation on March 8. “At our institution, we continue to perform sentinel lymph node biopsy in patients with thin melanomas and ulceration and high mitotic rate.” The retrospective review of the melanoma database included cases from 1997 through 2008. The researchers analysed histopathologic and survival data to determine the rate of sentinel node positivity, and they also performed a multivariate analysis to identify clinical and pathological features predictive of sentinel lymph node positivity. Of the 472 patients in the database, Dr. Berkman observed that 43 (~9.1%) developed local or distant recurrence over a mean follow-up of 44.5 months. She said that 26 of these patients with recurrences died. Death occurred in 17 (4.1%) of sentinel lymph node biopsy-negative patients and in 9 (16.4%) of sentinel lymph node biopsy-positive patients (P = .001), she said. The rate of positive sentinel lymph node biopsies in patients with thin melanomas was 2.1% -- 3 positive findings among the 142 patients with thin melanomas, defined as a lesion <1 mm in depth. “In our cohort, Breslow depth, Clark level, and nodular subtype were significantly associated with sentinel lymph node biopsy positivity,” Dr. Berkman said. She also noted that ulceration status was associated with sentinel lymph node biopsy positivity, but it did not reach statistical significance. “Patients with thin melanomas and negative sentinel lymph node biopsies have a very low risk of recurrence and melanoma-related death,” she said. [Presentation title: Sentinel Lymph Node Biopsy for Cutaneous Melanoma: The Washington Cancer Institute Experience in 472 Patients, 1997-2008. Abstract P404] E-mail this page to a friend or colleague! To print, use this version