The effect of time to sentinel lymph node biopsy on cutaneous melanoma survival

Am J Surg. 2016 Nov;212(5):935-940. doi: 10.1016/j.amjsurg.2016.02.025. Epub 2016 May 12.

Abstract

Background: Whether timing of sentinel lymph node biopsy (SLNB) in cutaneous melanoma improves survival is not yet clear. The aim of this study was to investigate if the timing of SLNB influences long-term melanoma mortality.

Methods: A 10-year retrospective cohort study was conducted on 748 cutaneous melanoma patients who underwent excision of the SLN. Hazard ratios and 95% confidence intervals were estimated from Cox proportional hazards models.

Results: After adjusting for sex, age, Breslow thickness, mitotic rate, ulceration, and histologic type, patients who underwent early SLNB (≤30 days) and resulted positive on final pathology had a 3 times decreased risk of melanoma mortality (hazard ratio = .29; 95%confidence interval = .11 to .77) in comparison to patients who underwent delayed SLNB (≥31 days) and resulted positive on final pathology.

Conclusions: Our findings suggest that early SLNB (≤30 days) improves melanoma survival.

Keywords: Melanoma; Mortality; Sentinel lymph node; Timing.

MeSH terms

  • Adult
  • Aged
  • Cause of Death*
  • Cohort Studies
  • Confidence Intervals
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Melanoma / mortality*
  • Melanoma / pathology*
  • Melanoma / surgery
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Sentinel Lymph Node / pathology
  • Sentinel Lymph Node Biopsy / methods*
  • Skin Neoplasms / mortality*
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery
  • Statistics, Nonparametric
  • Survival Analysis
  • Time Factors
  • Treatment Outcome