Selective sentinel lymph node biopsy as a prognostic method in cutaneous malignant melanoma: a decade of experience

AimTo analyze the prognostic role of sentinel lymph node biopsy (SLNB) in patients with cutaneous malignant melanoma (MM).MethodsA retrospective study was conducted including patients with histologically proven and surgically resected MM with subsequent SLNB and clinical follow-up for at least 18 months. A survival analysis was performed using Kaplan-Meier method and univariate and multivariate Cox regression.ResultsTwo hundred and twenty-three consecutive patients (one hundred and one women) undergoing SLNB after MM diagnosis between 2011 and 2020 were included, ranging from 20 to 87 years (mean = 57.34 +/- 15.03 years). SLNB was positive for malignancy in 50/223 patients and post-SBLN staging was: Ia = 65; Ib = 40; IIa = 31; IIb = 27; IIc = 10; IIIa = 11; IIIb = 9 and IIIc = 30. Breslow (p < 0.001), Clark level (p = 0.001), mitosis rate (p = 0.001) and histologic type (p = 0.038) were associated significantly with the presence of lymph node metastases. SLNB result was a significant factor in overall survival (OS) (p < 0.001) and progression-free survival (PFS) (p < 0.001) showing a lower OS in patients with positive SLNB compared to those with negative. Univariate and multivariate Cox regression analyses showed that positive SLNB, lymphovascular invasion, and age were independents risk factor for OS and PFS.ConclusionIn our experience, and in accordance with the literature, detection of lymph node metastases by SLNB is a marker of tumor aggressiveness being associated with patient outcome.