In a systematic review and meta-analysis reported in The Lancet Oncology, Varey et al found that patients undergoing sentinel node biopsy (SLNB) for melanoma had reduced risk of melanoma-specific mortality and disease recurrence vs those who did not undergo SLNB.
Study Details
The analysis included 13 studies, with 40,287 patients, reported through January 2025 that included adult patients with cutaneous melanoma with data on SLNB and survival and provided adjusted risks for melanoma death, the primary outcome measure. Among these patients, 21,160 received SLNB and 19,127 did not.
Key Findings
The analysis showed that use of SLNB was associated with significantly reduced risk of melanoma-specific mortality vs no SLNB (hazard ratio [HR] = 0.86, 95% confidence interval [CI] = 0.81–0.92, P < .0001), with low heterogeneity (I² = 16%) among studies. Sensitivity analyses showed that SLNB benefit was not dependent on study weighting or use of systemic therapy in the studies.
Analysis of five studies (n = 27,540) that reported 5-year risk of melanoma-specific death showed a significant benefit with SLNB (HR = 0.84, 95% CI = 0.78–0.90, P < .0001), with low heterogeneity among studies (I² = 15%). Analysis of two studies including three estimates of 10-year risk of death from melanoma showed a nonsignificant benefit of SLNB (HR = 0.87, 95% CI = 0.71–1.06, P = .17), with higher heterogeneity among studies (I² = 41%). Analysis of nine studies (n = 11,625) reporting adjusted risk of recurrence showed reduced risk of disease recurrence with SLNB (HR = 0.71, 95% CI = 0.66–0.76, P < .0001), with low heterogeneity among studies (I² = 23%).
The investigators concluded: “This meta-analysis showed that people with melanoma who underwent SLNB had a significantly reduced risk of death from melanoma and recurrence compared with those who did not. These findings are consistent with the only published randomized controlled trial and were robust on sensitivity analyses, indicating that SLNB confers true survival and recurrence benefits.”
John F. Thompson, MBBS MD, of Melanoma Institute Australia, Sydney, is the corresponding author for The Lancet Oncology article.
DISCLOSURE: The investigators reported that there was no external funding for the study. For full disclosures of the study authors, visit thelancet.com.
