Summary
Between the years 2000–2010, 195 patients were diagnosed with ≥4 mm Breslow thickness
malignant melanoma in our unit. Median follow-up was 36.8 months. 49% of patients
were male and 51% were female. Median age was 74 years. The commonest melanoma type
was nodular (55%). The commonest tumour location was on the extremity (45%). 64% of
tumours were ulcerated. Median mitotic rate was 9. Median Breslow thickness was 7 mm
66 patients underwent sentinel lymph node biopsy. 44 (67%) patients had negative results
and the remaining 22 (33%) patients were positive for metastatic melanoma. There was
no statistically significant correlation between any of the patient or tumour variables
(age, sex, melanoma type, melanoma site, Clark level, Breslow thickness, mitotic rate,
ulceration) and sentinel lymph node status. Patients with Breslow thickness melanoma
of <6 mm had a significantly better 5-year disease free and overall survival compared
with those patients with >6 mm Breslow thickness melanoma (63.5% vs. 32.9%; P = 0.004 and 73.9% vs. 54.7%; P = 0.02 respectively). Recurrence rate was 50% in those with positive sentinel lymph
node biopsy compared to 23% in those with negative results. Distant recurrence was
the commonest in both groups. 5-year disease free survival was 64.1% in the SLNB –ve
group and 35.4% in the SLNB +ve group (P = 0.01). There was no significant difference in overall survival between the SLNB
–ve and SLNB +ve groups (70.3% vs. 63.7% respectively; P = 0.66). We conclude that sentinel lymph node biopsy in our unit has provided no
survival benefit in those with thick melanoma over the past 10 years but is an important
predictor of recurrence free survival. Breslow thickness remains an important predictor
of disease free and overall survival in thick melanoma.
Keywords
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Article info
Publication history
Published online: May 03, 2012
Accepted:
April 12,
2012
Received:
November 18,
2011
Footnotes
☆Article presented at BAPRAS Winter Scientific Meeting 2011.
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
