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A 10-year analysis of primary cutaneous malignant melanoma with sentinel lymph node biopsy and long-term follow-up.
MedLine Citation:
PMID:  23347311     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Sentinel lymph node biopsy (SLNB) is an important tool for accurate staging of patients with melanoma. There is an ongoing debate whether the procedure provides therapeutic benefits or not.
OBJECTIVE: We wanted to analyze 10-year data from an academic teaching hospital.
PATIENTS AND METHODS: During 1999-2009, 977 patients with early cutaneous melanoma have been treated. Of these, 419 patients had tumors ≥1 mm thickness. Patients with head and neck tumors were excluded, leaving 364 patients (202 men and 162 women). SLNB was not performed in 163 patients but was performed in 201 patients. For correction of bias, tumors >4 mm thickness were excluded from further statistical analysis.
RESULTS: The detection rate of SLN was 94.4%. False negative SLN were observed in 8.9%. Adverse effects occurred in 5.5%. The rate of positive SLNB was 16.4% and lymph node involvement 20%. Patients undergoing SLNB had a lower relapse rate (10.6% vs. 33.3%; P < 0.001). The most important finding is an almost 50% lower total death rate and melanoma-related death rate in the SLNB subgroup (P < 0.001 for both).
CONCLUSIONS: Sentinel lymph node biopsy is an accurate instrument for melanoma staging to detect occult regional lymph node involvement. Data suggest a positive effect on relapse-free survival. The observation of improved long-term survival needs validation in prospective multicenter trials. The limitations of this study were that it was a single center retrospective analysis.
Authors:
Josefine Beger; Gesina Hansel; Claudia Krönert; Martin Fuchs; Carmen Tanner; Jaqueline Schönlebe; Carmen Werner; Andreas Nowak; Gunter Haroske; Helmut Witzigmann; Uwe Wollina
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of dermatology     Volume:  52     ISSN:  1365-4632     ISO Abbreviation:  Int. J. Dermatol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243704     Medline TA:  Int J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  220-30     Citation Subset:  IM    
Copyright Information:
© 2013 The International Society of Dermatology.
Affiliation:
Departments/Institutes of the Academic Teaching Hospital, Dresden-Friedrichstadt, Dresden.
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