The following is a summary of “Differences in sentinel lymph node biopsy utilization in eligible melanoma patients treated with Mohs micrographic surgery or wide local excision: A population-based logistic regression model and survival analysis,” published in the APRIL 2023 issue of Dermatology by Knackstedt, et al.

The management of primary melanoma typically involves removing the tumor and conducting a sentinel lymph node biopsy (SLNB) for eligible patients. For a study, researchers sought to compare the utilization of SLNB in patients who underwent wide local excision (WLE) or Mohs micrographic surgery (MMS).

The retrospective study included patients with T1b melanoma from the Surveillance, Epidemiology, and End Results program who underwent either WLE or MMS. Propensity score matching was used to compare patients who underwent either procedure. Melanoma-specific survival was analyzed using Kaplan-Meier analysis and Fine-Gray cumulative incidence functions.

The study identified 825 cases of MMS and 38,760 cases of WLE. Of the MMS patients, 32.61% underwent SLNB, compared to 61.77% of WLE patients. The favorable rates for SLNB were 12.5% for MMS patients and 14.82% for WLE patients. Multiple logistic regression revealed that WLE, male gender, younger age, extremity location, and nodular and rare melanoma subtypes were significantly associated with increased odds of receiving SLNB, while head and neck location and lentigo maligna melanoma subtype were significantly less likely to receive SLNB.

Patients who underwent WLE for T1b melanoma were more likely to receive SLNB compared to patients undergoing MMS.

Reference; jaad.org/article/S0190-9622(22)02988-7/fulltext