Role and significance of sentinel lymph node biopsy for the treatment of melanoma of the extremities / 中华肿瘤杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the role of sentinel lymph node biopsy (SLNB) for the treatment of melanoma of the extremities.</p><p><b>METHODS</b>From April 2007 to August 2013, forty-eight (25 men and 23 women) cases of melanoma of the extremities underwent sentinel lymph node biopsy. All the cases had sentinel lymph node biopsy and surgery. Among them 37 cases underwent limb salvage surgery, while 11 cases underwent amputation. Of the cases with limb salvage, 28 cases underwent free skin grafting or local flap grafting reconstruction after wide resection. Of the surgical margin, wide resection was performed in 37 patients, and radical resection was performed in 11 cases. There were 39 cases in stage I or II, and 9 cases in stage III. After the surgery, adjuvant chemotherapy was performed in 9 cases, and adjuvant biotherapy of interferon and interleukin was performed in 26 cases. Except for 2 cases, 46 cases were followed up with a mean follow-up period of 20.1 months (range from 2 to 60 months).</p><p><b>RESULTS</b>39 (81.3%) cases had negative SLNB, while 9 (18.8%) cases had positive SLNB. Recurrence or metastasis was more common in those with positive SLNB (3 of 9 cases, 33.3%) compared with those with negative SLNB (4 of 39 cases, 10.3%). The median disease-free survival of patients with negative results was 19.5 months, significantly longer than that of the positive cases (9.5 months, P = 0.03). Otherwise, sex and age showed no significant difference in the disease free survivals.</p><p><b>CONCLUSIONS</b>Sentinel lymph node biopsy enables us to have a better understanding of regional lymph node status through lymphoscintigraphy. It improves the accuracy of staging and provides valuable prognostic information to guide subsequent treatment decisions.</p>