Role of sentinel lymph node biopsy in skin cancer patients

The objective of this paper was to determine how  skin cancer patients  with tumor thickness of > 4mm could benefit from a diagnostic procedure known as sentinel lymph node biopsy.

Melanoma is a type of cancer that starts in color-producing cells of the skin. It can grow deep into the inner layers of skin and spread into lymph nodes (tiny, bean-shaped organs that help fight infections). Depending upon how deep a melanoma reaches into the skin layer (also called thickness), treatment is determined. A sentinel lymph node biopsy (SLNB) is a procedure to find out if the skin cancer has reached the lymph nodes. This procedure is usually recommended for melanoma patients with medium tumor thickness (1-4 mm, stage T2- T3). The present paper analyzed SLNB results of patients with tumor thickness of >4 mm (stage T4).

All patients underwent a local surgery at the time of melanoma diagnosis. In all, SLNB results of 350 patients with average melanoma thickness of 7 mm were analyzed. Depending on the results, the patients were divided into three groups: 1) Negative SLNB group of 94 patients, i.e. the melanoma did not reach lymph nodes, 2) Positive SLNB group of 84 patients i.e. the melanoma reached lymph nodes and 3) Observation group of 172 patients who did not undergo  SLNB.

During follow-up, 68% of patients in observation group, 53% in the negative SLNB group and 65% in the positive SLNB group had a relapse (return of the cancer). Overall, those with a negative SLNB were 38% less likely to have a bad disease outcome with regards disease free survival (percentage of patients who were disease free) and disease free interval (length of time that patients were disease free) compared to those with positive SLNB and those under observation. The risk of relapse and death were lower in negative SLNB group of patients compared to patients in observation group.

The authors concluded that it is important for melanoma patients with > 4mm thickness to undergo SLNB to get an accurate estimation of disease outlook.