Sentinel lymph node biopsy for lentigo maligna melanoma under local anaesthesia
Julia Huynh, Ulrike Leiter, Claus Garbe, Galina Shiderova, Vincent Walter, Thomas Eigentler, Alexander Scheu, Hans‐Martin Häfner, Saskia Maria Schnabl- Infectious Diseases
- Dermatology
Abstract
Background
Lentigo maligna melanoma is mainly localised in the head and neck region in elderly patients. Due to its slow horizontal growth, it has a good prognosis compared to other melanoma subtypes, but specific data are rare.
Objectives
The aim of this study was to investigate sentinel lymph node biopsy in lentigo maligna melanoma under local anaesthesia and to discuss the benefit.
Methods
Investigation of patients with lentigo maligna melanoma and tumour thickness ≥1 mm treated at the Department of Dermatology, University Medical Centre Tuebingen, between January 2008 and October 2019.
Results
In total 204 patients (126 SLNB, 78 Non‐SLNB) with a median age of 75.7 years (SLNB: 73.3 years, Non‐SLNB: 79.7 years) could be included. 16 of 126 (12.7%) sentinel lymph nodes were positive. Five‐year overall survival was 87.9% (88.5% SLNB; 87.4% Non‐SLNB) and 5‐year distant metastasis‐free survival was 85.8% (85.4% SLNB; 86.7% Non‐SLNB). There was no significant difference for distant metastasis‐free survival (p=0.861) and overall survival (p=0.247) between patients with and without sentinel lymph node biopsy.
Conclusions
Sentinel lymph node biopsy in lentigo maligna melanoma under local anaesthesia is a safe and simple method, even in very old patients. However, LMM has a very good 5‐year overall survival. In high‐risk patients with high tumour thickness and/or ulceration, adjuvant immunotherapy can now be offered without the need to perform this procedure.