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Assessment of the role of sentinel lymph node biopsy for primary cutaneous desmoplastic melanoma†
Article first published online: 12 JAN 2006
Copyright © 2006 American Cancer Society
Volume 106, Issue 4, pages 900–906, 15 February 2006
How to Cite
Pawlik, T. M., Ross, M. I., Prieto, V. G., Ballo, M. T., Johnson, M. M., Mansfield, P. F., Lee, J. E., Cormier, J. N. and Gershenwald, J. E. (2006), Assessment of the role of sentinel lymph node biopsy for primary cutaneous desmoplastic melanoma. Cancer, 106: 900–906. doi: 10.1002/cncr.21635
The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Fax: (713) 745-4926
- Issue published online: 3 FEB 2006
- Article first published online: 12 JAN 2006
- Manuscript Accepted: 29 AUG 2005
- Manuscript Revised: 18 AUG 2005
- Manuscript Received: 9 MAY 2005
- The University of Texas M. D. Anderson Cancer Center Physician-Scientists Program
- UT M. D. Anderson Cancer Center SPORE in Melanoma. Grant Number: P50 CA93459
- desmoplastic melanoma;
- sentinel lymph node biopsy
The role of sentinel lymph node biopsy (SLNB) in the treatment of desmoplastic melanoma (DM) remains undefined. The purpose of this study was to evaluate the use of SLNB for DM.
In all, 1850 patients with cutaneous melanoma underwent wide local excision and SLNB. Patients with DM were identified and stratified as ‘pure’ DM or ‘mixed’ DM (i.e., DM associated with at least one other common histologic subtype).
Of the 1850 patients, 65 (3.5%) had DM. Of these, 46 (70.8%) had pure DM and 19 (29.2%) had mixed DM. Patients with pure DM had a median tumor thickness of 3.5 mm and 6.5% were ulcerated. Compared with patients with pure DM, patients with either mixed DM or non-DM (n = 1785) had thinner primary tumors (median, 1.7 mm and 1.5 mm, respectively, each P < 0.001 vs. pure DM) that were more likely to be ulcerated (27.7% and 21.3%, respectively, each P < 0.05 vs. pure DM). Although the incidence of a positive SLN was similar in patients with mixed DM (15.8%) and non-DM (17.5%), patients with pure DM were less likely to have a positive SLN (2.2%) (each P < 0.01 vs. non-DM and mixed DM). At a median follow-up of 2.9 years, no patient with pure DM had recurred.
Despite having thicker primary tumors, patients with pure DM have a lower incidence of positive SLNs compared with patients with non-DM. Whereas the treatment approach for patients with mixed DM should be similar to that of other melanoma patients, patients with pure DM are unlikely to have metastatic disease in regional lymph nodes and SLNB may not be warranted. Cancer 2006. © 2006 American Cancer Society.