Can sentinel node biopsy be safely omitted in thin melanoma? Risk factor analysis of 1272 multicenter prospective cases

Sara Di Lorenzo, Bartolo Corradino, Simone Ribero, Marco Ceresoli, Niccolò Allievi, Carlo Riccardo Rossi, Dario Piazzalunga, Pietro Quaglino, Simone Mocellin, Luca Giovanni Campana

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Abstract

Background: The indication to sentinel node biopsy (SNB) for thin melanomas (Breslow <1 mm) is stillsubject to controversies. The aim of this paper is to review all SNB performed for thin melanoma and toanalyze factors related to lymphatic metastasis. Moreover, the diagnostic performance of the 5th, 6th, 7thand 8th AJCC classifications for cutaneous melanoma were investigated.Methods: All sentinel node biopsies performed for thin melanomas were selected from a multicentreprospectively-collected database. For each patient the following was collected: age, sex, date of treatment, site of primary melanoma, histopathologic features (Breslow, Clark, number of mitoses/mm2,presence of ulceration) and the results of the sentinel node biopsy.Results: From 1998 to 2017 were performed a total of 1272 SNB for thin melanoma. Mean age was51years with 48.7% of male patients. Overall, 5.6% positive SNB were found. At univariate and multivariate analyses, Breslow thickness and ulceration were related to the presence of lymphatic metastasis.We compared the four versions of the AJCC classification: among pT1a patients there were respectively5.32%, 5.63%, 3.72% and 3.49% of positive SNB.Conclusions: in thin melanoma Breslow thickness and ulceration were the only factors related to apositive SNB. Although convincing improvements resulted from the implementation of AJCC classifications with a reduction of positive biopsies among pT1a, a 10.71% rate among all positive nodes remains inthe low-risk group. No recommendations can be drawn from this research and adjunctive evidences areneeded to better identify patients at risk of nodal metastasis.© 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical
Lingua originaleEnglish
pagine (da-a)820-824
Numero di pagine5
RivistaEuropean Journal of Surgical Oncology
Volume45
Stato di pubblicazionePublished - 2019

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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Di Lorenzo, S., Corradino, B., Ribero, S., Ceresoli, M., Allievi, N., Rossi, C. R., Piazzalunga, D., Quaglino, P., Mocellin, S., & Campana, L. G. (2019). Can sentinel node biopsy be safely omitted in thin melanoma? Risk factor analysis of 1272 multicenter prospective cases. European Journal of Surgical Oncology, 45, 820-824.