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Vol. 100. Issue 6.
Pages 486-492 (August 2009)
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Vol. 100. Issue 6.
Pages 486-492 (August 2009)
Original article
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Sentinel Node Biopsy as a Prognostic Factor in Cutaneous Melanoma
Biopsia del Ganglio Centinela como Factor Pronóstico en el Melanoma Cutáneo
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J.A. Avilés-Izquierdo
Corresponding author
dermaviles@yahoo.es

Correspondence: Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, C/ Dr. Esquerdo, 46, 28007 Madrid, Spain.
, P. Lázaro-Ochaita
Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Abstract
Background

The aim of sentinel node biopsy (SNB) is to identify subclinical lymph node metastases using a procedure with minimal morbidity, establish more accurate staging in patients with melanoma, determine prognosis, and choose the most suitable treatment in each patient.

Objectives

To analyze the outcomes of SNB in patients with cutaneous melanoma, and the impact of this procedure on survival.

Material and methods

Information was gathered retrospectively on all patients in whom this procedure was performed at Hospital General Universitario Gregorio Marañón, Madrid, Spain, over an 11-year period (1997-2007). Descriptive epidemiological analysis of the variables and survival analysis were performed.

Results

Sentinel node invasion by melanoma was present in 42 of 238 patients (17.6%). Tumor thickness and nodular melanomas were associated with the presence of lymph node micrometastases. There were no differences in overall survival, but disease-free survival was significantly lower in patients with a positive SNB, who also had a higher melanoma-related mortality.

Conclusions

Detection of lymph node micrometastases by sentinel node biopsy is a marker of tumor aggressiveness and an important prognostic factor in melanoma patients. Information from SNB permits better staging and determines the diagnostic and therapeutic approach in these patients.

Key words:
melanoma
sentinel node biopsy
epidemiology
survival
Resumen
Introducción

La biopsia del ganglio centinela (BGC) persigue la identificación de metástasis ganglionares subclínicas con una morbilidad mínima, una estadificación más precisa de los pacientes con melanoma, estimar el pronóstico de estos pacientes y adoptar el tratamiento más adecuado en cada caso.

Objetivos

Analizar los resultados obtenidos con esta técnica en pacientes con melanoma cutáneo y el impacto de la misma en su supervivencia.

Material y métodos

Se obtuvieron de forma retrospectiva los datos referentes a todos los pacientes a los que se les realizó esta técnica en el Hospital General Universitario Gregorio Marañón de Madrid durante 11 años (1997-2007). Se realizó un estudio epidemiológico descriptivo y un estudio analítico del impacto en la supervivencia.

Resultados

En 42 de 238 casos (17,6%) se encontró afectación del ganglio centinela por melanoma. El espesor tumoral y el tipo histológico nodular se asociaron a la presencia de micrometástasis ganglionares. Aunque el resultado del ganglio centinela no se asoció con una mayor supervivencia global, el tiempo libre de enfermedad fue significativamente inferior en los pacientes con ganglio centinela positivo, que además presentaron una mayor tasa de mortalidad por melanoma.

Conclusiones

La detección de micrometástasis ganglionares gracias a la BGC supone un marcador de agresividad y un importante factor pronóstico en los pacientes con melanoma. La información que nos aporta esta técnica nos permite una mejor estadificación, determinando la actitud diagnóstica y terapéutica a seguir en estos pacientes.

Palabras clave:
melanoma
ganglio centinela
epidemiología
supervivencia
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Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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