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Sentinel lymph node biopsy in acral melanoma: A Korean single-center experience with 107 patients (2006-2018).

Authors
  • Sohng, Chihyeon1
  • Sim, Hyun Bo2
  • Kim, Jun Young1
  • Lim, Yangsoo3
  • Han, Man Hoon4
  • Lee, Hoseok5
  • Ahn, Byeong-Cheol6
  • Huh, Seung3
  • Lee, Seok-Jong1
  • 1 Department of Dermatology, School of Medicine, Kyungpook National University Hospital, Daegu, South Korea. , (North Korea)
  • 2 Park and Lee Dermatologic Clinic, Daegu, South Korea. , (North Korea)
  • 3 Department of Surgery, School of Medicine, Kyungpook National University Hospital, Daegu, South Korea. , (North Korea)
  • 4 Department of Pathology, School of Medicine, Kyungpook National University Hospital, Daegu, South Korea. , (North Korea)
  • 5 Department of Radiology, School of Medicine, Kyungpook National University Hospital, Daegu, South Korea. , (North Korea)
  • 6 Department of Dermatology, Nuclear Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea. , (North Korea)
Type
Published Article
Journal
Asia-Pacific journal of clinical oncology
Publication Date
Oct 20, 2020
Identifiers
DOI: 10.1111/ajco.13425
PMID: 33079454
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Sentinel lymph node biopsy (SLNB) of primary cutaneous melanoma as an important staging method has not been popularly undertaken in Korea and only a few studies with small patient numbers have been published. We examined the clinical feasibility and overall outcomes of SLNB in acral melanoma (AM) of Korean in Kyungpook National University Hospital (KNUH) over the past 13 years. SLNB in AM patients during 2006-2018 were analyzed retrospectively for sentinel lymph node (SLN) harvesting rate, positivity rate, positivity-relevant overall survival (OS) and disease-free survival (DFS), and its side effects. A total of 109 AM patients who underwent SLNB were enrolled. Harvested nodes were identified from 107 patients and SLN harvesting rate was 98.2%. The mean Breslow thickness (±standard deviation) was 3.38 ± 3.03 mm, and the proportion of ulcerated melanomas was 64%. Twenty-two (20.6%) had a tumor-positive SLN and, among them, 82% (18/22) underwent immediate complete lymph node dissection (CLND). The metastasis-positive nodal basin after CLND was detected in 16.7% of cases (3/18). Tumor-negative SLN cohorts showed significantly better OS and DFS than tumor-positive ones (P = 0.006 and P < 0.001 for each). Two side effects, one seroma and one lymphocele, were observed without major sequelae. SLNB, crucial management of melanoma, proved its efficacy to predict patients' prognosis and could be performed successfully and safely in Korean AM patients by interdisciplinary cooperation between dermatology and other surgical departments. SLN(-) showed significantly better OS and DFS than SLN(+). Significant risk factors for DFS were Breslow thickness, the presence of ulceration and the presence of SLN metastasis. SLNB should be encouraged in order to stage melanoma accurately and direct the proper management in Korean AM. © 2020 John Wiley & Sons Australia, Ltd.

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