Sentinel Lymph Node Biopsy for Recurrent Melanoma

A Multicenter Study

Georgia M. Beasley, Yinin Hu, Linda Youngwirth, Randall P. Scheri, April K. Salama, Kara Rossfeld, Syed Gardezi, Doreen M. Agnese, J. Harrison Howard, Douglas Tyler, Craig L. Slingluff, Alicia M. Terando

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Sentinel lymph node biopsy (SLNB) is routinely performed for primary cutaneous melanomas; however, limited data exist for SLNB after locally recurrent (LR) or in-transit (IT) melanoma. Methods: Data from three centers performing SLNB for LR/IT melanoma (1997 to the present) were reviewed, with the aim of assessing (1) success rate; (2) SLNB positivity; and (3) prognostic value of SLNB in this population. Results: The study cohort included 107 patients. Management of the primary melanoma included prior SLNB for 56 patients (52%), of whom 10 (18%) were positive and 12 had complete lymph node dissections (CLNDs). In the present study, SLNB was performed for IT disease (48/107, 45%) or LR melanoma (59/107, 55%). A sentinel lymph node (SLN) was removed in 96% (103/107) of cases. Nodes were not removed for four patients due to lymphoscintigraphy failures (2) or nodes not found during surgery (2). SLNB was positive in 41 patients (40%, 95% confidence interval (CI) 31.5–50.5), of whom 35 (88%) had CLND, with 13 (37%) having positive nonsentinel nodes. Median time to disease progression after LR/IT metastasis was 1.4 years (95% CI 0.75–2.0) for patients with a positive SLNB, and 5.9 years (95% CI 1.7–10.2) in SLNB-negative patients (p = 0.18). There was a trend towards improved overall survival for patients with a negative SLNB (p = 0.06). Conclusion: SLNB can be successful in patients with LR/IT melanoma, even if prior SLNB was performed. In this population, the rates of SLNB positivity and nonsentinel node metastases were 40% and 37%, respectively. SLNB may guide management and prognosis after LR/IT disease.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - May 15 2017

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Sentinel Lymph Node Biopsy
Multicenter Studies
Melanoma
Confidence Intervals
Lymph Node Excision
Neoplasm Metastasis
Lymphoscintigraphy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Beasley, G. M., Hu, Y., Youngwirth, L., Scheri, R. P., Salama, A. K., Rossfeld, K., ... Terando, A. M. (Accepted/In press). Sentinel Lymph Node Biopsy for Recurrent Melanoma: A Multicenter Study. Annals of Surgical Oncology, 1-6. https://doi.org/10.1245/s10434-017-5883-6

Sentinel Lymph Node Biopsy for Recurrent Melanoma : A Multicenter Study. / Beasley, Georgia M.; Hu, Yinin; Youngwirth, Linda; Scheri, Randall P.; Salama, April K.; Rossfeld, Kara; Gardezi, Syed; Agnese, Doreen M.; Howard, J. Harrison; Tyler, Douglas; Slingluff, Craig L.; Terando, Alicia M.

In: Annals of Surgical Oncology, 15.05.2017, p. 1-6.

Research output: Contribution to journalArticle

Beasley, GM, Hu, Y, Youngwirth, L, Scheri, RP, Salama, AK, Rossfeld, K, Gardezi, S, Agnese, DM, Howard, JH, Tyler, D, Slingluff, CL & Terando, AM 2017, 'Sentinel Lymph Node Biopsy for Recurrent Melanoma: A Multicenter Study', Annals of Surgical Oncology, pp. 1-6. https://doi.org/10.1245/s10434-017-5883-6
Beasley GM, Hu Y, Youngwirth L, Scheri RP, Salama AK, Rossfeld K et al. Sentinel Lymph Node Biopsy for Recurrent Melanoma: A Multicenter Study. Annals of Surgical Oncology. 2017 May 15;1-6. https://doi.org/10.1245/s10434-017-5883-6
Beasley, Georgia M. ; Hu, Yinin ; Youngwirth, Linda ; Scheri, Randall P. ; Salama, April K. ; Rossfeld, Kara ; Gardezi, Syed ; Agnese, Doreen M. ; Howard, J. Harrison ; Tyler, Douglas ; Slingluff, Craig L. ; Terando, Alicia M. / Sentinel Lymph Node Biopsy for Recurrent Melanoma : A Multicenter Study. In: Annals of Surgical Oncology. 2017 ; pp. 1-6.
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abstract = "Background: Sentinel lymph node biopsy (SLNB) is routinely performed for primary cutaneous melanomas; however, limited data exist for SLNB after locally recurrent (LR) or in-transit (IT) melanoma. Methods: Data from three centers performing SLNB for LR/IT melanoma (1997 to the present) were reviewed, with the aim of assessing (1) success rate; (2) SLNB positivity; and (3) prognostic value of SLNB in this population. Results: The study cohort included 107 patients. Management of the primary melanoma included prior SLNB for 56 patients (52{\%}), of whom 10 (18{\%}) were positive and 12 had complete lymph node dissections (CLNDs). In the present study, SLNB was performed for IT disease (48/107, 45{\%}) or LR melanoma (59/107, 55{\%}). A sentinel lymph node (SLN) was removed in 96{\%} (103/107) of cases. Nodes were not removed for four patients due to lymphoscintigraphy failures (2) or nodes not found during surgery (2). SLNB was positive in 41 patients (40{\%}, 95{\%} confidence interval (CI) 31.5–50.5), of whom 35 (88{\%}) had CLND, with 13 (37{\%}) having positive nonsentinel nodes. Median time to disease progression after LR/IT metastasis was 1.4 years (95{\%} CI 0.75–2.0) for patients with a positive SLNB, and 5.9 years (95{\%} CI 1.7–10.2) in SLNB-negative patients (p = 0.18). There was a trend towards improved overall survival for patients with a negative SLNB (p = 0.06). Conclusion: SLNB can be successful in patients with LR/IT melanoma, even if prior SLNB was performed. In this population, the rates of SLNB positivity and nonsentinel node metastases were 40{\%} and 37{\%}, respectively. SLNB may guide management and prognosis after LR/IT disease.",
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T1 - Sentinel Lymph Node Biopsy for Recurrent Melanoma

T2 - A Multicenter Study

AU - Beasley, Georgia M.

AU - Hu, Yinin

AU - Youngwirth, Linda

AU - Scheri, Randall P.

AU - Salama, April K.

AU - Rossfeld, Kara

AU - Gardezi, Syed

AU - Agnese, Doreen M.

AU - Howard, J. Harrison

AU - Tyler, Douglas

AU - Slingluff, Craig L.

AU - Terando, Alicia M.

PY - 2017/5/15

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N2 - Background: Sentinel lymph node biopsy (SLNB) is routinely performed for primary cutaneous melanomas; however, limited data exist for SLNB after locally recurrent (LR) or in-transit (IT) melanoma. Methods: Data from three centers performing SLNB for LR/IT melanoma (1997 to the present) were reviewed, with the aim of assessing (1) success rate; (2) SLNB positivity; and (3) prognostic value of SLNB in this population. Results: The study cohort included 107 patients. Management of the primary melanoma included prior SLNB for 56 patients (52%), of whom 10 (18%) were positive and 12 had complete lymph node dissections (CLNDs). In the present study, SLNB was performed for IT disease (48/107, 45%) or LR melanoma (59/107, 55%). A sentinel lymph node (SLN) was removed in 96% (103/107) of cases. Nodes were not removed for four patients due to lymphoscintigraphy failures (2) or nodes not found during surgery (2). SLNB was positive in 41 patients (40%, 95% confidence interval (CI) 31.5–50.5), of whom 35 (88%) had CLND, with 13 (37%) having positive nonsentinel nodes. Median time to disease progression after LR/IT metastasis was 1.4 years (95% CI 0.75–2.0) for patients with a positive SLNB, and 5.9 years (95% CI 1.7–10.2) in SLNB-negative patients (p = 0.18). There was a trend towards improved overall survival for patients with a negative SLNB (p = 0.06). Conclusion: SLNB can be successful in patients with LR/IT melanoma, even if prior SLNB was performed. In this population, the rates of SLNB positivity and nonsentinel node metastases were 40% and 37%, respectively. SLNB may guide management and prognosis after LR/IT disease.

AB - Background: Sentinel lymph node biopsy (SLNB) is routinely performed for primary cutaneous melanomas; however, limited data exist for SLNB after locally recurrent (LR) or in-transit (IT) melanoma. Methods: Data from three centers performing SLNB for LR/IT melanoma (1997 to the present) were reviewed, with the aim of assessing (1) success rate; (2) SLNB positivity; and (3) prognostic value of SLNB in this population. Results: The study cohort included 107 patients. Management of the primary melanoma included prior SLNB for 56 patients (52%), of whom 10 (18%) were positive and 12 had complete lymph node dissections (CLNDs). In the present study, SLNB was performed for IT disease (48/107, 45%) or LR melanoma (59/107, 55%). A sentinel lymph node (SLN) was removed in 96% (103/107) of cases. Nodes were not removed for four patients due to lymphoscintigraphy failures (2) or nodes not found during surgery (2). SLNB was positive in 41 patients (40%, 95% confidence interval (CI) 31.5–50.5), of whom 35 (88%) had CLND, with 13 (37%) having positive nonsentinel nodes. Median time to disease progression after LR/IT metastasis was 1.4 years (95% CI 0.75–2.0) for patients with a positive SLNB, and 5.9 years (95% CI 1.7–10.2) in SLNB-negative patients (p = 0.18). There was a trend towards improved overall survival for patients with a negative SLNB (p = 0.06). Conclusion: SLNB can be successful in patients with LR/IT melanoma, even if prior SLNB was performed. In this population, the rates of SLNB positivity and nonsentinel node metastases were 40% and 37%, respectively. SLNB may guide management and prognosis after LR/IT disease.

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