Sentinel lymph node biopsy or nodal observation in melanoma: study of an Italian series

G Ital Dermatol Venereol. 2013 Jun;148(3):299-305.

Abstract

Aim: The purpose of this study was to investigate the disease-free time (DFT) and overall survival (OS) of patients with intermediate or high-risk cutaneous melanoma who were treated with conventional surgery alone, and to compare them with that of a second group of patients who were treated with surgery and SLN biopsy.

Methods: A retrospective, single-centre study was performed at the Department of Dermatology of the "M. Bufalini" Hospital, Cesena, Italy based on data collected between January 1990 and December 2007. A total of 757 consecutive patients with stage I-II melanoma were identified: the former group (control group), treated with conventional surgery, was composed of 224 patients; the latter, treated with surgery and SLN biopsy (SLN biopsy group), was formed of 529 patients.

Results: The 5-year disease free time (DFT) rate, estimated with Kaplan-Meyer, was 73.9% (95% CI: 67.5-79.2) in the control group, and 82.2% (95% CI: 78.6-85.3) in the SLN biopsy group. Although the DFT rate was significantly higher in the SLN group than in the control group in univariate analyses (P=0.004), this gain was lost in multivariate analysis (P=0.2). The 5-year overall survival (OS) rate was 88.4% (95% CI: 83.2-92.1) for the control group, and 87.9% (95% CI: 84.6-90.4) for the SLN biopsy group. Statistical comparison of specific OS was not statistically significant (P=0.93).

Conclusion: On the basis of our follow-up data, we found that patients who underwent SLN biopsy technique experienced a reduction in the proportion of lymph nodal relapse, but DFT and OS were statistically equivalent between the two groups.

MeSH terms

  • Adult
  • Disease-Free Survival
  • Female
  • Humans
  • Italy
  • Lymphatic Metastasis
  • Male
  • Melanoma / mortality
  • Melanoma / pathology*
  • Melanoma / surgery*
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy*
  • Skin Neoplasms / mortality
  • Skin Neoplasms / secondary*
  • Skin Neoplasms / surgery*
  • Survival Rate