Prognostic value of sentinel node biopsy in 327 prospective melanoma patients from a single institution

Abstract Aim To confirm the accuracy of sentinel node biopsy (SNB) procedure and its morbidity, and to investigate predictive factors for SN status and prognostic factors for disease-free survival (DFS) and disease-specific survival (DSS). Materials and methods Between October 1997 and December 2004, 327 consecutive patients in one centre with clinically node-negative primary skin melanoma underwent an SNB by the triple technique, i.e. lymphoscintigraphy, blue-dye and gamma-probe. Multivariate logistic regression analyses as well as the Kaplan–Meier were performed. Results Twenty-three percent of the patients had at least one metastatic SN, which was significantly associated with Breslow thickness ( p p p p  = 0.001). The presence of a metastatic SN (RR = 8.4, p p p  = 0.013) and ulceration (RR = 2.6, p  = 0.015) were significantly associated with a poorer DSS. Conclusion SNB is a reliable procedure with high sensitivity (91.4%) and low morbidity. Breslow thickness was the only statistically significant parameter predictive of SN status. DFS was worsened in decreasing order by Breslow thickness, metastatic SN and male gender. Similarly DSS was significantly worsened by a metastatic SN, male gender, Breslow thickness and ulceration. These data reinforce the SN status as a powerful staging procedure.