Evaluation of sentinel lymph node status in spindle cell melanomas

Background: The propensity for spindle cell melanoma to metastasize to the lymph node is relatively low despite its relative thick depth. To date, the re are no published reports on the sentinel lymph node (SLN) status in pati ents diagnosed with spindle cell melanoma and desmoplastic malignant melano ma (DMM). Objective: Our purpose was to report our experience on the SLN status in sp indle cell melanoma and DMM. Methods: We undertook a retrospective database and medical record review fr om Oct 21, 1993 to Sept 29, 1999. At the University of California at San Fr ancisco Melanoma Center, patients with tumor thickness greater than 1 mm or less than 1 mm with high-risk features are managed with preoperative lymph oscintigraphy selective SLN dissection, and wide excision. Results: Of 29 patients diagnosed with spindle cell melanoma and DMM, 28 ha d negative SLNs and are free of disease except for one patient who experien ced splenic, bony, and brain metastases. The mean followup in this populati on was 16.5 and 11 months, respectively. Conclusion: Our preliminary findings show that SLNs from patients diagnosed with spindle cell melanoma and DMM only rarely harbor micrometastasis desp ite their relative thickness. A larger number of cases from multicenter dat abases may further define the true biology of SLNs in this melanoma variant .