Prognostic usefulness of sentinel lymph node biopsy for patients who have clinically node negative, localized, primary invasive cutaneous melanoma: a Bayesian analysis using informative published reports.

Objective: To assess the prognostic value of sentinel lymph node biopsy status for patients with localized, clinically node negative, primary invasive cutaneous melanoma.

Design: Predictive value of positive or negative sentinel lymph node biopsy (SLNB) results for melanoma-related death, using raw numbers from informative publications.

Setting And Participants: Reports comprising 50 patients with cutaneous melanoma who had undergone SLNB, based on PubMed search (January 1, 1993, through June 3, 2010).

Main Outcome Measure: Melanoma-related death.

Results: For the 2 informative reports of patients with tumors of intermediate thickness (1-4 mm), risk of melanoma-related death ranged from 26.2% to 31.6% for node-positive cases and from 9.7% to 15.6% for node-negative cases. Based on 4 informative reports of patients with thin tumors (≤ 1 mm), risk of melanoma-related death ranged from 0% to 0.6% for both node-positive and node-negative cases. For the single informative report of patients with thick tumors (≥ 4 mm), risk of melanoma-related death was 32.5% for node-positive cases and 30.1% for node-negative cases. For 19 informative case series with any tumor thickness, risk of melanoma-related death ranged from 0% to 47.8% for node-positive cases and from 0% to 13.3% for node-negative cases.

Conclusion: Prognostic information provided by SLNB status may be variably useful for patients who have tumors of intermediate thickness (1-4 mm) and not very useful for patients who have thin (≤ 1 mm) or thick (≥ 4 mm) tumors.