Sentinel Node Biopsy as a Prognostic Factor in Cutaneous Melanoma

Abstract

Background The aim of sentinel node biopsy (SNB) is to identify subclinical lymph node metastases using a procedure with minimal morbidity, establish more accurate staging in patients with melanoma, determine prognosis, and choose the most suitable treatment in each patient. Objectives To analyze the outcomes of SNB in patients with cutaneous melanoma, and the impact of this procedure on survival. Material and methods Information was gathered retrospectively on all patients in whom this procedure was performed at Hospital General Universitario Gregorio Marañón, Madrid, Spain, over an 11-year period (1997-2007). Descriptive epidemiological analysis of the variables and survival analysis were performed. Results Sentinel node invasion by melanoma was present in 42 of 238 patients (17.6%). Tumor thickness and nodular melanomas were associated with the presence of lymph node micrometastases. There were no differences in overall survival, but disease-free survival was significantly lower in patients with a positive SNB, who also had a higher melanoma-related mortality. Conclusions Detection of lymph node micrometastases by sentinel node biopsy is a marker of tumor aggressiveness and an important prognostic factor in melanoma patients. Information from SNB permits better staging and determines the diagnostic and therapeutic approach in these patients.