What is the role of sentinel node biopsy for desmoplastic melanomas?

Author(s):

A/Professor T Michael Hughes — Author
Dr David Gyorki MBBS, MD, FRACS — Co-author
Professor John Kelly — Co-author
A/Prof Jonathan R. Stretch — Co-author
Professor Richard A. Scolyer — Co-author
Dr Alexander Varey — Co-author
Clinical Professor Angela Hong — Co-author
Cancer Council Australia Melanoma Guidelines Working Party — Co-author

In partnership with:

Melanoma Institute Australia

Cite this page

A/Professor T Michael Hughes, Cecilia Taing, Dr David Gyorki MBBS, MD, FRACS, Kelly, J, Stretch, J, Scolyer, R, Dr Alexander Varey, Clinical Professor Angela Hong, Cancer Council Australia Melanoma Guidelines Working Party. Clinical question:What is the role of sentinel node biopsy for desmoplastic neurotropic melanomas? . In: Clinical practice guidelines for the diagnosis and management of melanoma. Sydney: Melanoma Institute Australia. [Version URL: https://wiki.cancer.org.au/australiawiki/index.php?oldid=186422, cited 2023 Oct 1]. Available from: https://wiki.cancer.org.au/australia/Guidelines:Melanoma.

Last modified:
24 May 2018 00:11:24

Introduction

Regional lymph node involvement rates have been reported to be lower in all desmoplastic melanomas (DM) and, as a result, recommendations pertaining to sentinel lymph node biopsy (SLNB) for the staging of primary cutaneous melanoma may not be applicable. This may particularly be the case for pure DM (pDM) whereas mixed DM (mDM) regional lymph node metastasis rates approach those of non-DM.

Systematic review evidence

Dunne et al (2016)^[1] published a systematic review of 16 case series that reported the sentinel node status in patients with DM. The results for the 1519 patients showed a positive sentinel node rate for all DM of 6.5%. This compares with an expected rate of 15–20% for non DM. The rate was significantly lower for pDM (5.4%) compared with mDM (13.8%). The reviewers concluded that SLNB should be considered for patients with mDM, as it would be for non-DM, but not for pDM.

Evidence summary and recommendations

Evidence summary	Level	References
A systematic review of 16 case series comprising results for 1519 patients showed a positive sentinel node rate for all DM of 6.5%. This compares with an expected rate of 15–20% for non DM. The rate was significantly lower for pDM (5.4%) compared with mDM (13.8%).	III-1	^[1]