Can sentinel lymph node biopsy predict outcome in locally recurrent or in-transit melanomas?

This study investigated the role of sentinel node biopsy (SLNB) in locally recurrent (LR; when the cancer comes back) melanoma or in-transit (IT; spreads to a lymph vessel before it reaches the nearest lymph node) melanoma. Researchers suggested that SLNB should be performed in these patients.

The sentinel lymph node is the first lymph node that may be affected by the cancer. The detection of cancer cells in the sentinel node by SLNB predicts spread to other parts of the body (metastasis).

After the initial surgery, 2 to 10% of melanomas will locally recur as small tumors around the main tumor, IT, or LR disease. A prior study found that SLNB predicted time to metastasis in IT disease. SLNB-positive patients were metastasis-free for an average of 19 months, compared to 70 months in SLNB-negative patients. This study involved a relatively small number of patients. Further studies of the long-term predictive role of SLNB are needed.

This study aimed to determine the predictive role of SLNB in IT or LR melanoma.

This study included information about 107 patients. 55% underwent SLNB for LR. 45% underwent SLNB for IT. A sentinel lymph node was removed in 96% of the cases. SLNB was positive in 40%. 37% had melanoma spread to the lymph nodes.

The average time to progression in patients with positive SLNB was 1.4 years, compared to 5.9 years in negative SLNB patients. There was a slight improvement of the overall survival in patients with negative SLNB.

This study determined that SLNB is predictive of time to metastasis in patients with IT and LR melanomas.