FOLLOW-UP OF 300 MELANOMA PATIENTS SUBMITTED TO SENTINEL NODE BIOPSY

AIMS: Information of prognosis for patients with cutaneous melanoma is sparse and controversial. An understanding of the pattern of recurrence after melanoma’s surgical treatments is helpful in coordinating a rational plan of follow-up in these patients. METHODS: From January 1999 to December 2007, 300 consecutive patients with primary cutaneous malignant melanoma stage I or II (AJCC) were enrolled. Patients were divided into three groups according to Breslow thickness: 4 mm (32 pts). All patients underwent regular follow-up with clinical examination, US, chest x-ray and PET. RESULT: The median follow-up time from the date of primary melanoma diagnosis was 60 months (range, 12 – 108 months). The rate of development of skin recurrence was respectively in the three groups 1.2 % (1 pts/82), 7.5 % (14pts/186) and 18.8 % (6pts/32). With regard to nodal recurrence rates were 1.2 % (1 pts/82), 2.7 % (5 pts/186), 9.3 % (3 pts/ 32) and the percentage of distant metastases had the following distribution 1.2 % (1 pts/82), 5.9 % (11 pts/186) and 18.8 % (6 pts/32). The relationship between the number of deaths related to disease and sentinel lymph node (SLN) status was respectively in the three groups: two deaths both (100 %) with negative SLN, 19 of which 11 (57.9 %) with negative SLN and 7 of which 3 (42.9 %) with negative SLN. CONCLUSION: Further data will better clarify the role of prognostic factors to identify cases with a more aggressive biological behaviour of the disease. Has confirmed the importance of Breslow thickness as a prognostic factor, remains doubtful the prognostic value of sentinel lymph node biopsy. Therefore, regardless of the tumor-positive sentinel lymph node, is needful a close clinical and instrumental follow-up