Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2011

01-02-2011 | Melanomas

Sentinel Node Dissection Delays Recurrence and Prolongs Melanoma-Related Survival: An Analysis of 673 Patients from a Single Center with Long-Term Follow-Up

Authors: I. Satzger, MD, A. Meier, L. Hoy, MD, B. Völker, MD, A. Kapp, MD, A. Hauschild, MD, R. Gutzmer, MD

Published in: Annals of Surgical Oncology | Issue 2/2011

Login to get access

Abstract

Background

The status of the sentinel lymph node is an important predictor for survival in melanoma patients, but it is still unclear if early removal of micrometastases by sentinel lymph node dissection (SLND) alters survival. A large series of melanoma patients from a single center with long-term follow-up was analyzed with regard to a possible effect of SLND on the prognosis.

Materials and Methods

A total of 673 consecutive melanoma patients were assessed treated in our center either without SLND (377 patients, pre-SLN group, between January 1995 and March 2000) or with SLND (296 patients, SLN group, between April 2000 and March 2003). The median follow-up was 64.0 months in the pre-SLN and 72.5 months in the SLN group.

Results

The pre-SLN group and SLN group did not differ significantly with regard to characteristics of the primary melanoma thickness and ulceration, sex, and age. Kaplan–Meier analyses showed a significantly better recurrence-free survival (P < .001), distant metastases free survival (P = .006), and overall survival (P = .049) for patients of the SLN group; the 5-year melanoma-specific survival rates were 80.3% in pre-SLN patients and 84.8% in SLN patients. Initial metastases in the in-transit region and distant locations were of similar frequency in the pre-SLN and SLN groups (P = .191 and P = .959, respectively), but initial regional lymph node metastases were significantly more frequent in the pre-SLN group (P < .001).

Conclusions

Our data point toward a subgroup of melanoma patients who might have a prognostic benefit from SLN.
Literature
1.
Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27:6199–206.CrossRefPubMed
2.
Gershenwald JE, Thompson W, Mansfield PF, Lee JE, Colome MI, Tseng CH, et al. Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients. J Clin Oncol. 1999;17:976–83.PubMed
3.
Gutzmer R, Al Ghazal M, Geerlings H, Kapp A. Sentinel node biopsy in melanoma delays recurrence but does not change melanoma-related survival: a retrospective analysis of 673 patients. Br J Dermatol. 2005;153:1137–41.CrossRefPubMed
4.
McMasters KM. What good is sentinel lymph node biopsy for melanoma if it does not improve survival? Ann Surg Oncol. 2004;11:810–2.CrossRefPubMed
5.
Medalie N, Ackerman AB. Sentinel node biopsy has no benefit for patients whose primary cutaneous melanoma has metastasized to a lymph node and therefore should be abandoned now. Br J Dermatol. 2004;151:298–307.CrossRefPubMed
6.
Morton DL, Cochran AJ. The case for lymphatic mapping and sentinel lymphadenectomy in the management of primary melanoma. Br J Dermatol. 2004;151:308–19.CrossRefPubMed
7.
Kretschmer L, Hilgers R, Mohrle M, Balda BR, Breuninger H, Konz B, et al. Patients with lymphatic metastasis of cutaneous malignant melanoma benefit from sentinel lymphadenectomy and early excision of their nodal disease. Eur J Cancer. 2004;40:212–8.CrossRefPubMed
8.
Morton DL, Hoon DS, Cochran AJ, Turner RR, Essner R, Takeuchi H, et al. Lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: therapeutic utility and implications of nodal microanatomy and molecular staging for improving the accuracy of detection of nodal micrometastases. Ann Surg. 2003;238:538–49.PubMed
9.
Starz H, De Donno A, Balda BR. The Augsburg experience: histological aspects and patient outcomes. Ann Surg Oncol. 2001;8:48S–51S.PubMed
10.
Thomas JM. Prognostic false-positivity of the sentinel node in melanoma. Nat Clin Pract Oncol. 2008;5:18–23.CrossRefPubMed
11.
Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Elashoff R, Essner R, et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med. 2006;355:1307–17.CrossRefPubMed
12.
Gimotty PA, Yoon F, Hammond R, Rosenbaum P, Guerry D. Therapeutic effect of sentinel lymph node biopsy in melanoma remains an open question. J Clin Oncol. 2009;27:4236–8.CrossRefPubMed
13.
14.
Amersi F, Morton DL. The role of sentinel lymph node biopsy in the management of melanoma. Adv Surg. 2007;41:241–56.CrossRefPubMed
15.
Gutzmer R, Kaspari M, Brodersen JP, Mommert S, Voelker B, Kapp A, et al. Specificity of tyrosinase and HMB45 PCR in the detection of melanoma metastases in sentinel lymph node biopsies. Histopathology. 2002;41:510–8.CrossRefPubMed
16.
van Akkooi AC, Voit CA, Verhoef C, Eggermont AM. New developments in sentinel node staging in melanoma: controversies and alternatives. Curr Opin Oncol. 2010;22:169–77.CrossRefPubMed
17.
van Akkooi AC, Nowecki ZI, Voit C, Schafer-Hesterberg G, Michej W, de Wilt JH, et al. Sentinel node tumor burden according to the Rotterdam criteria is the most important prognostic factor for survival in melanoma patients: a multicenter study in 388 patients with positive sentinel nodes. Ann Surg. 2008;248:949–55.CrossRefPubMed
18.
Satzger I, Volker B, Al Ghazal M, Meier A, Kapp A, Gutzmer R. Prognostic significance of histopathological parameters in sentinel nodes of melanoma patients. Histopathology. 2007;50:764–72.CrossRefPubMed
19.
van Akkooi A, de Wilt J, Verhoef C, Schmitz P, van Geel A, Eggermont A, et al. Clinical relevance of melanoma micrometastases (<0.1 mm) in sentinel nodes: are these nodes to be considered negative? Ann Oncol. 2006;17:1578–85.CrossRefPubMed
20.
Meier A, Satzger I, Voelker B, Kapp A, Gutzmer R. Comparison of classification systems in melanoma sentinel nodes—An analysis of 697 patients from a single center. Cancer. 2010;116:3178–88.CrossRefPubMed
21.
Murugkar P, Azawi K, Humzah D. The sleeper cells: delayed sentinel lymph node biopsy. J Plast Reconstr Aesthet Surg. 2007;60:1357–60.CrossRefPubMed
22.
Starz H, Siedlecki K, Balda BR. Sentinel lymphadenectomy and s-classification: a successful strategy for better prediction and improvement of outcome of melanoma. Ann Surg Oncol. 2004;11:162S–8S.PubMed
23.
Satzger I, Völker B, Meier A, Schenck F, Kapp A. Gutzmer R. Prognostic significance of isolated HMB45 or Melan A positive cells in Melanoma sentinel lymph nodes. Am J Surg Pathol. 2007;31:1175–80.CrossRefPubMed
24.
Kretschmer L, Beckmann I, Thoms KM, Haenssle H, Bertsch HP, Neumann C. Sentinel lymphadenectomy does not increase the risk of loco-regional cutaneous metastases of malignant melanomas. Eur J Cancer. 2005;41:531–8.CrossRefPubMed
25.
Thomas JM, Patocskai EJ. The argument against sentinel node biopsy for malignant melanoma. BMJ. 2000;321:3–4.CrossRefPubMed
26.
Thomas JM, Clark MA. Selective lymphadenectomy in sentinel node-positive patients may increase the risk of local/in-transit recurrence in malignant melanoma. Eur J Surg Oncol. 2004;30:686–91.CrossRefPubMed
27.
Kretschmer L, Beckmann I, Thoms KM, Mitteldorf C, Bertsch HP, Neumann C. Factors predicting the risk of in-transit recurrence after sentinel lymphadenectomy in patients with cutaneous malignant melanoma. Ann Surg Oncol. 2006;13:1105–12.CrossRefPubMed
28.
Francken AB, Accortt NA, Shaw HM, Wiener M, Soong SJ, Hoekstra HJ, et al. Prognosis and determinants of outcome following locoregional or distant recurrence in patients with cutaneous melanoma. Ann Surg Oncol. 2008;15:1476–84.CrossRefPubMed
29.
Masback A, Olsson H, Westerdahl J, Ingvar C, Jonsson N. Prognostic factors in invasive cutaneous malignant melanoma: a population-based study and review. Melanoma Res. 2001;11:435–45.CrossRefPubMed
30.
Janku F, Kurzrock R. Adjuvant interferon in high-risk melanoma: end of the era? J Clin Oncol. 2010;28:e15–6.CrossRefPubMed
31.
Garbe C, Eigentler T. Diagnosis and treatment of cutaneous melanoma: state of the art 2006. Melanoma Res. 2007;17:117–27.CrossRefPubMed
32.
Eggermont AM, Suciu S, MacKie R, Ruka W, Testori A, Kruit W, et al. Post-surgery adjuvant therapy with intermediate doses of interferon alfa 2b versus observation in patients with stage IIb/III melanoma (EORTC 18952): randomised controlled trial. Lancet. 2005;366:1189–96.CrossRefPubMed
33.
Eggermont AM, Suciu S, Santinami M, Testori A, Kruit WH, Marsden J, et al. Adjuvant therapy with pegylated interferon alfa-2b versus observation alone in resected stage III melanoma: final results of EORTC 18991, a randomised phase III trial. Lancet. 2008;372:117–26.CrossRefPubMed
Metadata
Title
Sentinel Node Dissection Delays Recurrence and Prolongs Melanoma-Related Survival: An Analysis of 673 Patients from a Single Center with Long-Term Follow-Up
Authors
I. Satzger, MD
A. Meier
L. Hoy, MD
B. Völker, MD
A. Kapp, MD
A. Hauschild, MD
R. Gutzmer, MD
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1318-3

Other articles of this Issue 2/2011

Annals of Surgical Oncology 2/2011 Go to the issue

Breast Oncology

Resection Margins in Ultrasound-Guided Breast-Conserving Surgery

Melanomas

In Reply: Sentinel Lymph Node Biopsy in Melanoma

Gastrointestinal Oncology

How Closely Should We Follow Gastric Cancer Patients Following Surgical Resection?

Breast Oncology

Twelve-Month Follow-Up Results of a Trial Utilizing Axxent Electronic Brachytherapy to Deliver Intraoperative Radiation Therapy for Early-Stage Breast Cancer

Translational Research and Biomarkers

Serum Midkine Correlates with Tumor Progression and Imatinib Response in Gastrointestinal Stromal Tumors

Endocrine Tumors

Disease-Free Survival and Time Bias in Long-Term Follow-Up After Complete Resection of Localized Well-Differentiated Cancer