The following is a summary of “Sentinel lymph node biopsy status improves adjuvant therapy decision-making in patients with clinical stage IIB/C melanoma: A population-based analysis,” published in the APRIL 2023 issue of Dermatology by Sharon, et al.

Sentinel lymph node (SLN) biopsy effectiveness for patients with clinical stage IIB/C melanoma has been questioned in light of the outcomes of the most recent KEYNOTE-716 experiment. Therefore, for a study, researchers sought to analyze the value of SLN status in influencing the suggestions for adjuvant therapy.

The Surveillance, Epidemiology, and End Results database was used to locate patients having wide local excision and SLN biopsy for clinical stage IIB/C cutaneous melanoma between 2004 and 2011. Two prognostic models were created to predict melanoma-specific death (MSD) probability. One included SLN status, whereas the other did not (MSD). The main result showed net benefit at 20% to 40% risk of 5-year MSD treatment criteria.

The 5-year MSD rate was 46% for the 4,391 patients that were enrolled. Compared to the model without SLN status, the 5-year MSD risk estimation model that considered SLN status produced higher net benefits at treatment thresholds between 30% and 78%. The additional net advantage for the SLN biopsy-containing model sustained in the subgroup analysis of patients in various age groups and T stages.

For threshold mortality rates ≥30%, SLN status-based prognostic models that predicted patient risk for 5-year MSD offered a greater net benefit than models that just considered primary tumor staging criteria.

Reference: jaad.org/article/S0190-9622(22)03133-4/fulltext