SLN status delivers vital prognosis in stage IIB/C cutaneous melanoma

The status of sentinel lymph nodes (SLN) can help predict the course of the disease in patients with clinical stage IIB/C cutaneous melanoma, suggests a study.

“Approval of adjuvant antiprogrammed cell death protein 1 therapy for pathologic stage IIB/C cutaneous melanoma has led some to question the role of SLN biopsy in the clinical stage IIB/C disease,” the researchers said.

This retrospective cohort study was conducted to determine the prognostic value of SLN staging on disease-specific survival (DSS) for clinical stage IIB/C primary cutaneous melanoma in the preimmunotherapy era. Melanoma patients who underwent excision were identified using the Surveillance, Epidemiology, and End Results database (2004-2011).

The researchers then compared patients who did and did not undergo SLN biopsy using propensity matching. Among participants who underwent SLN biopsy, matched patients were further stratified by their SLN status: SLN positive (SLN+) or SLN negative (SLN-).

A total of 8,562 patients were assessed, of whom 6,021 (70.3 percent) underwent SLN biopsy. SLN positive patients had a significantly lower 5-year DSS compared with matched counterparts who underwent SLN biopsy (47.1 percent SLN+ vs 75.5 percent SLN-; p<0.001).

Significant differences persisted in the 5-year DSS across matched T-stages: T3b (54.2 percent SLN+ vs 64.8 percent SLN-; p=0.004), T4a (55.5 percent SLN+ vs 71.6 percent SLN-; p=0.001), and T4b (38.6 percent SLN+ vs 60.9 percent SLN-; p<0.001).

“For patients with clinical stage IIB/C cutaneous melanoma, SLN status provides essential prognostic information,” the researchers said.

This study was limited by its retrospective design.