Background: Since the introduction of sentinel lymph node biopsy (SLNB), its use as a standard of care for patients\nwith clinically node-negative cutaneous melanoma remains controversial. We wished to evaluate our experience of\nSLNB for melanoma.\nMethods: A single center observational cohort of 203 melanoma patients with a primary cutaneous melanoma\n(tumour thickness > 1 mm) and without clinical evidence of metastasis was investigated from 2002 to 2009. Head\nand neck melanoma were excluded. SLN was identified following preoperative lymphoscintigraphy and\nintraoperative gamma probe interrogation.\nResults: The SLN identification rate was 97%. The SLN was tumor positive in 44 patients (22%). Positive SLN was\nsignificantly associated with primary tumor thickness and microscopic ulceration. The median follow-up was 39.5\n(5ââ?¬â??97) months. Disease progression was significantly more frequent in SLN positive patients (32% vs 13%, p = 0.002).\nFive-year DFS and OS of the entire cohort were 79.6% and 84.6%, respectively, with a statistical significant\ndifference between SLN positive (58.7% and 69.7%) and SLN negative (85% and 90.3%) patients (p = 0.0006 and\np = 0.0096 respectively). Postoperative complications after SLNB were observed in 12% of patients.\nConclusion: Our data confirm previous studies and support the clinical usefulness of SLNB as a reliable and\naccurate staging method in patients with cutaneous melanoma. However, the benefit of additional CLND in\npatients with positive SLN remains to be demonstrated.
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