Using Sentinel Lymph Node Biopsy for Thick (>4 mm) Head and Neck Melanoma

Objectives:Sentinel lymph node biopsy (SLNB) has become standard practice for intermediate-thickness head and neck melanoma (HNM) but remains controversial for melanomas >4 mm thick. The objectives of this study were to evaluate the diagnostic accuracy and the prognostic value of SLNB in patients with thick HNM.Methods:Retrospective cohort study of patients undergoing SLNB for thick HNM at a large cancer center between June 2000 and December 2012. Univariate and multivariate analysis of prognostic factors was performed. False negative SLNB was defined as recurrence within a previously identified negative nodal basin.Results:A total of 107 patients with thick HNMs were identified, of which 77 met inclusion criteria. Population characteristics included a mean patient age of 62.9 (range 4-87) with a male predominance (82%). Mean Breslow thickness was 6.04 mm (range 4-21 mm). Of the 77 patients undergoing attempted SLNB, 7 had no identifiable SLN (9%). For the remaining 91% with identifiable SLN(s), the mean ...