Time from melanoma excision to sentinel node biopsy does not affect outcomes

A short interval as compared to a long one between the primary melanoma excision and obtaining a sentinel lymph node biopsy specimen demonstrate similar patient outcomes, reports a recent study.

“Obtaining a sentinel lymph node biopsy specimen is a standard staging procedure in the management of cutaneous melanoma,” the authors said. “However, there is no consensus on the safe time interval between the primary melanoma biopsy procedure and the [sentinel node] procedure.”

To examine the link between time from excision to sentinel lymph node biopsy and patient outcomes for melanoma, a systematic review and meta-analysis was performed based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Six retrospective studies met the eligibility criteria. A total of 9,705 patients were identified, of whom 4,383 underwent a sentinel lymph node biopsy procedure at a time interval defined as early and 4,574 at an interval defined as late.

The combined hazard ratio (HR) was 1.25 (95 percent confidence interval [CI], 0.92–1.68), and a high heterogeneity (I², 83 percent; p=0.002) of the sentinel lymph node biopsy time interval on melanoma-specific survival was noted. For disease-free survival, the combined HR was 1.05 (95 percent CI, 0.95–1.15), with low heterogeneity (I², 9 percent; p=0.36).

Finally, in terms of overall survival, the combined HR was 1.25 (95 percent CI, 0.92–1.70), with low heterogeneity (I², 37 percent; p=0.2).

Heterogeneity between some studies was the major limitation of this research.