Evaluation of Sentinel Lymph Node Biopsy and Predictors of False-negative Sentinel Lymph Node Biopsy in Cutaneous Malignant Melanoma: A Single-center Study

Aim: Our purpose was to determine the constraints of sentinel lymph node biopsy (SLNB) in malignant melanoma (MM) and to optimize the necessity for additional research to enhance its precision. Materials and Methods: This retrospective study investigated the factors that influence the results of SLNB performed on patients with MM. Eighty-five patients with primary cutaneous MM were analyzed by their histopathological data, surgical records, and clinical follow-up information. An evaluation was conducted on variables including Breslow thickness, Clark level, mitotic rate, lymphatic and vascular invasion, negative predictive value (NPV), and SLNB results. Results: The statistical analysis showed that increased Breslow thickness, lymphatic or vascular invasion, and the presence of ulceration were found to have a significant impact on SLNB positivity. However, there was no correlation found between Clark level and SLNB outcomes. For the NPV of the test, it decreases with increasing Clark level and mitotic rate, as well as lymphatic or vascular invasion. In our study, the NPV was calculated as 81%. We also calculated the false-negative rate, which was found to be 19%. Conclusions: Further, investigation is warranted to optimize SLNB methodologies. To achieve this, we recommend additional investigations to refine SLNB techniques, explore unidentified risk factors, and incorporate advanced imaging methods for better detection of hidden lymph node metastases. In summary, understanding the factors influencing SLNB outcomes in MM is crucial for developing effective treatments and follow-up protocols. Key variables to consider in assessing nodal involvement include Breslow thickness and lymphatic or vascular invasion, among others.