Sentinel lymph node biopsy in melanoma: Our 8-year clinical experience in a single French institute (2002–2009)
Identifieur interne : 000211 ( France/Analysis ); précédent : 000210; suivant : 000212Sentinel lymph node biopsy in melanoma: Our 8-year clinical experience in a single French institute (2002–2009)
Auteurs : Caroline Biver-Dalle [France] ; Eve Puzenat [France] ; Marc Puyraveau [France] ; Delphine Delroeux [France] ; Hatem Boulahdour [France] ; Frances Sheppard [France] ; Fabien Pelletier [France] ; Philippe Humbert [France] ; François Aubin [France]Source :
- BMC Dermatology [ 1471-5945 ] ; 2012.
Abstract
Since the introduction of sentinel lymph node biopsy (SLNB), its use as a standard of care for patients with clinically node-negative cutaneous melanoma remains controversial. We wished to evaluate our experience of SLNB for melanoma.
A single center observational cohort of 203 melanoma patients with a primary cutaneous melanoma (tumour thickness > 1 mm) and without clinical evidence of metastasis was investigated from 2002 to 2009. Head and neck melanoma were excluded. SLN was identified following preoperative lymphoscintigraphy and intraoperative gamma probe interrogation.
The SLN identification rate was 97%. The SLN was tumor positive in 44 patients (22%). Positive SLN was significantly associated with primary tumor thickness and microscopic ulceration. The median follow-up was 39.5 (5–97) months. Disease progression was significantly more frequent in SLN positive patients (32% vs 13%, p = 0.002). Five-year DFS and OS of the entire cohort were 79.6% and 84.6%, respectively, with a statistical significant difference between SLN positive (58.7% and 69.7%) and SLN negative (85% and 90.3%) patients (p = 0.0006 and p = 0.0096 respectively). Postoperative complications after SLNB were observed in 12% of patients.
Our data confirm previous studies and support the clinical usefulness of SLNB as a reliable and accurate staging method in patients with cutaneous melanoma. However, the benefit of additional CLND in patients with positive SLN remains to be demonstrated.
Url:
DOI: 10.1186/1471-5945-12-21
PubMed: 23228015
PubMed Central: 3538072
Affiliations:
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last="Biver-Dalle">Caroline Biver-Dalle</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Dermatology, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Dermatology, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Puzenat, Eve" sort="Puzenat, Eve" uniqKey="Puzenat E" first="Eve" last="Puzenat">Eve Puzenat</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Dermatology, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Dermatology, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Puyraveau, Marc" sort="Puyraveau, Marc" uniqKey="Puyraveau M" first="Marc" last="Puyraveau">Marc Puyraveau</name><affiliation wicri:level="3"><nlm:aff id="I2">Clinical Methodology Center, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Clinical Methodology Center, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Delroeux, Delphine" sort="Delroeux, Delphine" uniqKey="Delroeux D" first="Delphine" last="Delroeux">Delphine Delroeux</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Digestive Surgery, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Surgery, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Boulahdour, Hatem" sort="Boulahdour, Hatem" uniqKey="Boulahdour H" first="Hatem" last="Boulahdour">Hatem Boulahdour</name><affiliation wicri:level="3"><nlm:aff id="I4">Department of Nuclear Medicine, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Nuclear Medicine, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Sheppard, Frances" sort="Sheppard, Frances" uniqKey="Sheppard F" first="Frances" last="Sheppard">Frances Sheppard</name><affiliation wicri:level="3"><nlm:aff id="I2">Clinical Methodology Center, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Clinical Methodology Center, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Pelletier, Fabien" sort="Pelletier, Fabien" uniqKey="Pelletier F" first="Fabien" last="Pelletier">Fabien Pelletier</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Dermatology, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Dermatology, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I5">University of Franche Comté, UMR1098, SFR FED4234, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Franche Comté, UMR1098, SFR FED4234, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Humbert, Philippe" sort="Humbert, Philippe" uniqKey="Humbert P" first="Philippe" last="Humbert">Philippe Humbert</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Dermatology, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Dermatology, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I5">University of Franche Comté, UMR1098, SFR FED4234, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Franche Comté, UMR1098, SFR FED4234, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Aubin, Francois" sort="Aubin, Francois" uniqKey="Aubin F" first="François" last="Aubin">François Aubin</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Dermatology, Besançon University Hospital, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Dermatology, Besançon University Hospital, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I6">University of Franche Comté, EA3181, SFR FED4234, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Franche Comté, EA3181, SFR FED4234, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I7">Service de Dermatologie, 2 Place Saint-Jacques, 25030, Besançon, cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Dermatologie, 2 Place Saint-Jacques, 25030, Besançon, cedex</wicri:regionArea><wicri:noRegion>cedex</wicri:noRegion><wicri:noRegion>cedex</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Dermatology</title><idno type="eISSN">1471-5945</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Since the introduction of sentinel lymph node biopsy (SLNB), its use as a standard of care for patients with clinically node-negative cutaneous melanoma remains controversial. We wished to evaluate our experience of SLNB for melanoma.</p></sec><sec><title>Methods</title><p>A single center observational cohort of 203 melanoma patients with a primary cutaneous melanoma (tumour thickness > 1 mm) and without clinical evidence of metastasis was investigated from 2002 to 2009. Head and neck melanoma were excluded. SLN was identified following preoperative lymphoscintigraphy and intraoperative gamma probe interrogation.</p></sec><sec><title>Results</title><p>The SLN identification rate was 97%. The SLN was tumor positive in 44 patients (22%). Positive SLN was significantly associated with primary tumor thickness and microscopic ulceration. The median follow-up was 39.5 (5–97) months. Disease progression was significantly more frequent in SLN positive patients (32% vs 13%, p = 0.002). Five-year DFS and OS of the entire cohort were 79.6% and 84.6%, respectively, with a statistical significant difference between SLN positive (58.7% and 69.7%) and SLN negative (85% and 90.3%) patients (p = 0.0006 and p = 0.0096 respectively). Postoperative complications after SLNB were observed in 12% of patients.</p></sec><sec><title>Conclusion</title><p>Our data confirm previous studies and support the clinical usefulness of SLNB as a reliable and accurate staging method in patients with cutaneous melanoma. However, the benefit of additional CLND in patients with positive SLN remains to be demonstrated.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Morton, Dl" uniqKey="Morton D">DL Morton</name></author><author><name sortKey="Wen, Dr" uniqKey="Wen D">DR Wen</name></author><author><name sortKey="Wong, Jh" uniqKey="Wong J">JH Wong</name></author><author><name sortKey="Economou, Js" uniqKey="Economou J">JS Economou</name></author><author><name sortKey="Cagle, La" uniqKey="Cagle L">LA Cagle</name></author><author><name sortKey="Storm, Fk" uniqKey="Storm F">FK Storm</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lourari, S" uniqKey="Lourari S">S Lourari</name></author><author><name sortKey="Paul, C" uniqKey="Paul C">C Paul</name></author><author><name sortKey="Gouraud, Pa" uniqKey="Gouraud P">PA Gouraud</name></author><author><name sortKey="Tavitian, S" uniqKey="Tavitian S">S 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O">O Béatrix</name></author><author><name sortKey="Balme, B" uniqKey="Balme B">B Balme</name></author><author><name sortKey="Thomas, L" uniqKey="Thomas L">L Thomas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morton, Dl" uniqKey="Morton D">DL Morton</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kretschmer, L" uniqKey="Kretschmer L">L Kretschmer</name></author><author><name sortKey="Thoms, K M" uniqKey="Thoms K">K-M Thoms</name></author><author><name sortKey="Peeters, S" uniqKey="Peeters S">S Peeters</name></author><author><name sortKey="Haenssle, H" uniqKey="Haenssle H">H Haenssle</name></author><author><name sortKey="Bertsch, H P" uniqKey="Bertsch H">H-P Bertsch</name></author><author><name sortKey="Emmert, S" uniqKey="Emmert S">S Emmert</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Voit, Ca" uniqKey="Voit C">CA Voit</name></author><author><name sortKey="Van Akkooi, Ajc" uniqKey="Van Akkooi A">AJC van Akkooi</name></author><author><name sortKey="Sch Fer Hesterberg, G" uniqKey="Sch Fer Hesterberg G">G Schäfer-Hesterberg</name></author><author><name sortKey="Sterry, W" uniqKey="Sterry W">W Sterry</name></author><author><name sortKey="Eggermont, Amm" uniqKey="Eggermont A">AMM Eggermont</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li></country><region><li>Bourgogne-Franche-Comté</li><li>Franche-Comté</li></region><settlement><li>Besançon</li></settlement></list><tree><country name="France"><region name="Bourgogne-Franche-Comté"><name sortKey="Biver Dalle, Caroline" sort="Biver Dalle, Caroline" uniqKey="Biver Dalle C" first="Caroline" last="Biver-Dalle">Caroline Biver-Dalle</name></region><name sortKey="Aubin, Francois" sort="Aubin, Francois" uniqKey="Aubin F" first="François" last="Aubin">François Aubin</name><name sortKey="Aubin, Francois" sort="Aubin, Francois" uniqKey="Aubin F" first="François" last="Aubin">François Aubin</name><name sortKey="Aubin, Francois" sort="Aubin, Francois" uniqKey="Aubin F" first="François" last="Aubin">François Aubin</name><name sortKey="Boulahdour, Hatem" sort="Boulahdour, Hatem" uniqKey="Boulahdour H" first="Hatem" last="Boulahdour">Hatem Boulahdour</name><name sortKey="Delroeux, Delphine" sort="Delroeux, Delphine" uniqKey="Delroeux D" first="Delphine" last="Delroeux">Delphine Delroeux</name><name sortKey="Humbert, Philippe" sort="Humbert, Philippe" uniqKey="Humbert P" first="Philippe" last="Humbert">Philippe Humbert</name><name sortKey="Humbert, Philippe" sort="Humbert, Philippe" uniqKey="Humbert P" first="Philippe" last="Humbert">Philippe Humbert</name><name sortKey="Pelletier, Fabien" sort="Pelletier, Fabien" uniqKey="Pelletier F" first="Fabien" last="Pelletier">Fabien Pelletier</name><name sortKey="Pelletier, Fabien" sort="Pelletier, Fabien" uniqKey="Pelletier F" first="Fabien" last="Pelletier">Fabien Pelletier</name><name sortKey="Puyraveau, Marc" sort="Puyraveau, Marc" uniqKey="Puyraveau M" first="Marc" last="Puyraveau">Marc Puyraveau</name><name sortKey="Puzenat, Eve" sort="Puzenat, Eve" uniqKey="Puzenat E" first="Eve" last="Puzenat">Eve Puzenat</name><name sortKey="Sheppard, Frances" sort="Sheppard, Frances" uniqKey="Sheppard F" first="Frances" last="Sheppard">Frances Sheppard</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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