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

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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]
Evidence-based recommendationQuestion mark transparent.png Grade
SLNB should be considered for patients with DM, as it would be for non-DM.

See When is a sentinel node biopsy indicated?

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References

  1. 1.0 1.1 Dunne JA, Wormald JC, Steele J, Woods E, Odili J, Powell BW. Is sentinel lymph node biopsy warranted for desmoplastic melanoma? A systematic review. J Plast Reconstr Aesthet Surg 2016 Nov 16 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28017261.


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