Influence of sentinel lymph node biopsy on the prognosis of acral melanoma patients^*

Abstract

Background:  Sentinel lymph node (SLN) biopsy in melanoma patients has an important role in staging, prognosis assessment, and treatment definition. Few studies have evaluated its role in the Acral Melanoma (AM) subtype.

Objective:  To evaluate the results of SLN biopsy in 79 patients with acral melanoma treated at a single oncological center and compare them with the data described in the literature.

Methods:  Between January 2016 and December 2022, the authors analyzed all patients with AM who underwent SLN biopsy in a single institute. The authors analyzed the epidemiological, clinical and histopathological data. Overall Survival (OS) and Disease-Free Survival (DFS) curves were estimated using the Kaplan-Meier method. Multivariate analyses were conducted using the Cox regression model.

Results:  During the period, the authors analyzed 79 cases. The mean age was 60 years and median thickness was 4.5 mm and 67.1% had ulceration. SLN was positive in 27 patients (34.2%). The estimated OS and DFS were 67.7% and 45.2%. OS was better in the negative SLN group compared to the positive SLN group (70.9% vs. 53.2%), but without statistical significance (p = 0.08). Estimated DFS for positive SLN was associated with a significantly worse prognosis (33.8 × 46.7%, p = 0.001).

Study limitations:  The retrospective nature of the study and the limited number of patients. Conclusions: The present study has significant implications for determining prognosis. Patients with AM and positive SLN had a worst prognosis compared to those with negative SLN.

KEYWORDS
Biopsy; Melanoma; Prognosis; Sentinel lymph node