For patients with clinical stage IIB/C melanoma, a prognostic model with sentinel lymph node (SLN) status provides benefit for predicting the risk for melanoma-specific death (MSD), according to a study published in the April issue of the Journal of the American Academy of Dermatology.

Cimarron E. Sharon, M.D., from the University of Pennsylvania Perelman School of Medicine, and colleagues examined the utility of SLN status in guiding the recommendations for adjuvant therapy among patients with clinical stage IIB/C cutaneous melanoma who underwent wide local excision and SLN biopsy between 2004 and 2011. The risk for MSD was predicted in two prognostic models, with and without SLN status.

The five-year rate of MSD was 46 percent for the 4,391 patients included. The researchers found that compared with the model without SLN status, the model estimating five-year MSD risk that included SLN status provided greater net benefit at treatment thresholds from 30 to 78 percent. The added net benefit persisted in a subgroup analysis of patients in different age groups and with various T stages.

"Foregoing SLN biopsy in these patients precludes the ability to perform complete pathologic staging and may negatively impact decision-making for providing adjuvant treatment based on accurate risk-assessment for melanoma-related death," the authors write.

Two authors disclosed financial ties to the biopharmaceutical industry.