Wide local excisions (WLEs) do not negatively affect the results of sentinel lymph node biopsies (SLNBs) in patients with head and neck primary cutaneous melanoma, according to an oral presentation given at the 2018 American Head & Neck Society Annual Meeting in National Harbor, Maryland.1

For this study, researchers reviewed 391 cases of patients with head and neck primary cutaneous melanoma who underwent SLNB. Of the included cases, 8% (30) underwent previous WLE, 27% (105) underwent Mohs/excisional biopsy, 18% (69) underwent punch biopsy, and 28% (110) underwent shave biopsy; the biopsy pattern of 19% (77) of patients were unknown. The median tumor thickness was 1.9 mm and median follow-up was 2.6 years.

Sentinel nodes were accurately identified in all 30 patients who underwent WLE.

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At the final follow-up, there were 50 cases of regional recurrence in the neck post-SLNB after a median 1.2 years, and 27 local recurrences after a median 1.0 years.

Following SLNB, 4 patients who underwent WLE had regional recurrence after 0.7 years, 20 patients with Mohs/excisional biopsy had recurrence after a median 1.3 years, and 19 patients with punch/shave biopsies had recurrence after a median 1.2 years. The regional recurrence-free survival rates were 87%, 83%, 78%, 77%, and 77% after 2, 4, 6, 8, and 10 years after SLNB, respectively.

No significant differences among biopsy techniques with regards to time to local/regional recurrence or death were observed.

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The authors concluded that “[w]e continue to recommend performing a wide local excision and sentinel lymph node biopsy in a single stage procedure to minimalize mortality and morbidity of staging procedures for malignant melanoma of the head and neck.”


May M, Janus J. Outcomes of biopsy techniques prior to sentinel lymph node biopsy for primary cutaneous melanoma of the head and neck. Oral presentation at: 2018 American Head & Neck Society Annual Meeting; April 18-19, 2018; National Harbor, MD.

This article originally appeared on Cancer Therapy Advisor