Prospective study of sentinel lymph node biopsy for conjunctival melanoma

• Published in: British journal of ophthalmology Vol. 97; no. 12; pp. 1525 - 1529
• Main Authors: Cohen, Victoria M L, Tsimpida, Maria, Hungerford, John L, Jan, Hikmat, Cerio, Rino, Moir, Graeme
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.12.2013; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Adolescent; Adult; Aged; Biopsy; Child; Clinical Science; Conjunctiva; Conjunctival Neoplasms - diagnostic imaging; Conjunctival Neoplasms - epidemiology; Conjunctival Neoplasms - pathology; Dissection; Enzyme Inhibitors; Female; Follow-Up Studies; Humans; Incidence; Lymphatic system; Male; Medical imaging; Melanoma; Melanoma - diagnostic imaging; Melanoma - epidemiology; Melanoma - secondary; Metastasis; Methylene Blue; Middle Aged; Mortality; Neck; Neoplasia; Neoplasm Staging; Patients; Prevalence; Prospective Studies; Radionuclide Imaging; Sentinel Lymph Node Biopsy - methods; Sentinel Lymph Node Biopsy - statistics & numerical data; Skin cancer; Technetium; Tumors; Ultrasonic imaging; Young Adult; Conjunctiva; Neoplasia
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2013-303671

Background To report our experience with sentinel lymph node biopsy for staging patients with conjunctival melanoma. Methods A prospective review of patients with conjunctival melanoma who underwent sentinel lymph node biopsy at St Bartholomew's Hospital from May 2008 to May 2012. The selection criterion for sentinel node biopsy depended on the tumour thickness (≥2 mm) and location of the conjunctival melanoma. The main outcome measures were the incidence of sentinel lymph node positivity and the procedure-related complications. Results In 4 years, 26 out of 70 patients met the selection criteria for sentinel lymph node biopsy. 4 patients declined and 22 patients consented for the procedure. Technetium-99m failed to identify a sentinel lymph node in four of the 22 patients (18%). Of the remaining 18 patients, two were found to have subclinical micrometastasis in regional lymph nodes. Median follow-up was 20 months (range 6–36 months). No false-negative events were observed. Complications of the procedure included transient blue staining of the epibulbar surface in five patients and transient facial nerve palsy in one patient. Conclusions Sentinel lymph node biopsy is a safe procedure with minimal complications. It should be considered for the staging of conjunctival melanomas, especially melanomas in non-limbal location or conjunctival melanomas ≥2 mm thick.