Sentinel Lymph Node Biopsy in Patients With Acral Melanoma: Analysis of 201 Cases From the Brazilian National Cancer Institute

BACKGROUND Sentinel lymph node biopsy (SLNB) is the most powerful predictor of relapse-free survival (RFS) and overall survival (OS). No studies have evaluated survival of acral melanoma (AM) undergoing SLNB in Brazil. OBJECTIVE The objective of this study was to investigate the factors associated with the survival of patients with AM undergoing SLNB. MATERIALS AND METHODS Patients diagnosed with AM and submitted to SLNB were included in this study. We evaluated the epidemiologic, clinical, and histopathological data. Overall survival and RFS curves were estimated using the Kaplan-Meier method. Multivariable analyses were conducted using the Cox regression model. RESULTS Among the 201 patients, 117 (58.2%) were female. The median age was 64 years old. Median tumor depth was 5.0 mm. Lesions were ulcerated in 134 (66.7%). Five-year OS and RFS rates were 44.6% and 38.6%, respectively. Median follow-up time was 39 months. The factors associated with OS were Breslow thickness, ulceration, and SLNB status, and for RFS, they were Breslow thickness and SLNB status. CONCLUSION This is the largest series of AM submitted to SLNB. The 5-year OS and RFS rates were low (44.6% and 38.6%, respectively), and the main prognostic factors for OS were Breslow thickness, ulceration, and the status of SLNB.