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Open Access Research article

Sentinel lymph node biopsy in melanoma: Our 8-year clinical experience in a single French institute (2002–2009)

Caroline Biver-Dalle1, Eve Puzenat1, Marc Puyraveau2, Delphine Delroeux3, Hatem Boulahdour4, Frances Sheppard2, Fabien Pelletier15, Philippe Humbert15 and François Aubin167*

Author affiliations

1 Department of Dermatology, Besançon University Hospital, Besançon, France

2 Clinical Methodology Center, Besançon University Hospital, Besançon, France

3 Department of Digestive Surgery, Besançon University Hospital, Besançon, France

4 Department of Nuclear Medicine, Besançon University Hospital, Besançon, France

5 University of Franche Comté, UMR1098, SFR FED4234, Besançon, France

6 University of Franche Comté, EA3181, SFR FED4234, Besançon, France

7 Service de Dermatologie, 2 Place Saint-Jacques, 25030, Besançon, cedex, France

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Citation and License

BMC Dermatology 2012, 12:21  doi:10.1186/1471-5945-12-21

Published: 10 December 2012

Abstract

Background

Since the introduction of sentinel lymph node biopsy (SLNB), its use as a standard of care for patients with clinically node-negative cutaneous melanoma remains controversial. We wished to evaluate our experience of SLNB for melanoma.

Methods

A single center observational cohort of 203 melanoma patients with a primary cutaneous melanoma (tumour thickness > 1 mm) and without clinical evidence of metastasis was investigated from 2002 to 2009. Head and neck melanoma were excluded. SLN was identified following preoperative lymphoscintigraphy and intraoperative gamma probe interrogation.

Results

The SLN identification rate was 97%. The SLN was tumor positive in 44 patients (22%). Positive SLN was significantly associated with primary tumor thickness and microscopic ulceration. The median follow-up was 39.5 (5–97) months. Disease progression was significantly more frequent in SLN positive patients (32% vs 13%, p = 0.002). Five-year DFS and OS of the entire cohort were 79.6% and 84.6%, respectively, with a statistical significant difference between SLN positive (58.7% and 69.7%) and SLN negative (85% and 90.3%) patients (p = 0.0006 and p = 0.0096 respectively). Postoperative complications after SLNB were observed in 12% of patients.

Conclusion

Our data confirm previous studies and support the clinical usefulness of SLNB as a reliable and accurate staging method in patients with cutaneous melanoma. However, the benefit of additional CLND in patients with positive SLN remains to be demonstrated.

Keywords:
Melanoma; Sentinel lymph node