Department/Institutes of the Academic Teaching Hospital, Dresden-Friedrichstadt, Dresden, Germany.
Int J Dermatol. 2013 Feb;52(2):220-30. doi: 10.1111/j.1365-4632.2012.05706.x.
Sentinel lymph node biopsy (SLNB) is an important tool for accurate staging of patients with melanoma. There is an ongoing debate whether the procedure provides therapeutic benefits or not.
We wanted to analyze 10-year data from an academic teaching hospital.
During 1999-2009, 977 patients with early cutaneous melanoma have been treated. Of these, 419 patients had tumors ≥ 1 mm thickness. Patients with head and neck tumors were excluded, leaving 364 patients (202 men and 162 women). SLNB was not performed in 163 patients but was performed in 201 patients. For correction of bias, tumors >4 mm thickness were excluded from further statistical analysis.
The detection rate of SLN was 94.4%. False negative SLN were observed in 8.9%. Adverse effects occurred in 5.5%. The rate of positive SLNB was 16.4% and lymph node involvement 20%. Patients undergoing SLNB had a lower relapse rate (10.6% vs. 33.3%; P < 0.001). The most important finding is an almost 50% lower total death rate and melanoma-related death rate in the SLNB subgroup (P < 0.001 for both).
Sentinel lymph node biopsy is an accurate instrument for melanoma staging to detect occult regional lymph node involvement. Data suggest a positive effect on relapse-free survival. The observation of improved long-term survival needs validation in prospective multicenter trials. The limitations of this study were that it was a single center retrospective analysis.
前哨淋巴结活检（SLNB）是一种用于准确分期黑色素瘤患者的重要工具。目前仍在争论该程序是否具有治疗益处。
我们希望分析一家学术教学医院的 10 年数据。
在 1999 年至 2009 年间，对 977 例早期皮肤黑色素瘤患者进行了治疗。其中，419 例患者的肿瘤厚度≥1 毫米。排除头颈部肿瘤患者，留下 364 例患者（202 名男性和 162 名女性）。163 例患者未行 SLNB，但 201 例患者行 SLNB。为了纠正偏差，将肿瘤厚度>4 毫米的病例排除在进一步的统计分析之外。
SLN 的检出率为 94.4%。假阴性 SLN 占 8.9%。出现不良反应 5.5%。SLNB 阳性率为 16.4%，淋巴结受累率为 20%。行 SLNB 的患者复发率较低（10.6% vs. 33.3%；P < 0.001）。最重要的发现是，在 SLNB 亚组中，总死亡率和黑色素瘤相关死亡率几乎降低了 50%（两者均 P < 0.001）。
前哨淋巴结活检是一种用于检测隐匿性区域淋巴结受累的黑色素瘤分期的准确工具。数据表明对无复发生存有益。前瞻性多中心试验需要进一步验证长期生存的改善观察。本研究的局限性在于它是一项单中心回顾性分析。
