Long-Term Evaluation of Patients With Clinical Node-Negative Malignant Melanoma: A Tertiary Single Center Experience

Abstract

Introduction: We aimed to investigate the prognostic factors for patients with cutaneous malignant melanoma undergoing sentinel lymph node biopsy. Materials and Methods: Patients who underwent sentinel lymph node biopsy between January 2004 and December 2019 were reviewed retrospectively. Demographic characteristics, tumor location, thickness and other histopathological features, number and status of lymph nodes removed in SLNB, results of elective lymph node dissection in SLNB-positive patients, distant and local metastases, mortality, and follow-up periods were recorded. Results: There were 222 patients, 96 females, with an age range of 54.25 +/- 16.34 years. Mean tumor thickness was 3.65 +/- 2.87 mm. Disease-free survival was calculated as 78.4 +/- 56.79 months. Sixty-five patients (29.2%) had positive sentinel lymph node biopsies. Recurrence, defined as local, regional, or distant metastasis, mortality and mortality and/or recurrence was observed in 14.4%, 20.7% and 29.7% of patients, respectively. Sex, tumor thickness, presence of comorbidities, ulceration, and positive sentinel lymph nodes were found to be independent risk factors affecting mortality. Presence of ulceration and lymphatic invasion were independent risk factors for recurrence. Tumor thickness >2 mm led to a significantly shorter survival than the ones with tumor thickness <2 mm. Conclusion: The 5-year survival rate for malignant melanoma was found to be significantly higher in comparison to other studies in the literature. Additionally, acral lentiginous melanoma exhibited a significantly higher prevalence compared to nodular melanoma.