Melanoma
Michael Fadel, BSc (Hons) MBBS MRCS
Speciality Registrar in General Surgery
The Sarcoma, Melanoma and Rare Tumours Unit, The Royal Marsden Hospital and Institute Cancer of Research, London, UK
London, England, United Kingdom
Disclosure: Disclosure information not submitted.
The mean age was 60 (16-89) years and 88 (46.1%) were female patients. Melanoma was mainly found on the extremity (97/191, 50.8%), followed by the trunk (70/191, 36.6%) and head and neck (24/191, 12.6%). The most common types of melanoma were superficial spreading (90/191, 47.1%) and nodular (48/191, 25.1%) melanoma. The mean Breslow thickness was 2.61 mm and 88 (46.1%) patients had ulceration and 81 (42.4%) patients had mitosis > 1 mm2.
The number of nodes per patient detected in group A were 1.67 and group B were 1.46 (p = 0.189). The accuracy detection rate of SLN in group A and B was 95.9% and 89.8% respectively (p = 0.13). The false negative rate in group A was 4.1% and 2.5% in group B (p = 0.55). The mean operative time in group A was 102 minutes and 111 minutes in group B (p = 0.34).
Thirty (15.7%) patients had immunotherapy. Fifteen (7.9%) patients had recurrence – local (8/15, 53.3%) and distant (7/15, 46.7%) recurrence. At a mean follow-up of two years, 157 patients (82.2%) had no disease and 3 (1.6%) patients died as a result of the disease.
Conclusions: ICG is a useful adjunct to radioisotope in SLN biopsy in melanoma and is comparable to blue dye. In our experience it has many technical advantages, with equivalent utility to blue dye.