Sentinel lymph node biopsy in the management of conjunctival melanoma: current insights

Figures & data

Figure 1 Melanoma of the temporal bulbar conjunctiva with a prominent feeder vessel in the left eye of a patient.

Table 1 Comparison of the two largest cohort studies investigating sentinel lymph node biopsy (SLNB) in conjunctival melanomas (CMs)

	Pfeiffer et al, 2017^Citation18	Cohen et al, 2013^Citation22
Number of patients	31	22
Median age	62 years (includes eyelid melanoma)	59 years
Requirements	No signs of metastasis, >17 years old, histologically confirmed CM, ≥1 mm or ulceration	>2 mm, unfavorable location, recurrent melanoma
SLNB not found	0/31 (0%)	4/22 (18%)
SLNB positive	4/31 (13%)	2/18 (11%)
SLNB false negative	2/27(7%), early cases	0/18 (0%)
Technique	Technecium-99m (Tc-99m) ± isosulfan blue	Tc-99m ± methylene blue
Median number of lymph nodes sampled	2	2
Follow-up	Median 61 months (includes eyelid melanoma)	Median 20 months
Recurrence-free survival	N/A	N/A
Metastasis-free survival	N/A	N/A
Overall survival	79% at 5 years (including cutaneous melanoma)	N/A
Complications	Facial nerve palsy (6%), neck hematoma (2%), stitch abscess (2%)	Blue staining of the conjunctiva (31%), facial nerve palsy (6%)

Table 2 List of sentinel lymph node biopsy (SLNB) reports in conjunctival melanoma and applied lymphatic mapping technique

	Number of patients	SLNB positive	Technique
Pfeiffer et al, 2017^Citation18	31	4	Technecium-99m (Tc-99m) + isosulfan blue
Cohen et al, 2013^Citation22	22	2	Tc-99m + methylene blue
Waintstein et al, 2014^Citation24	3	0	Tc-99m + isosulfan blue
Aziz et al, 2015^Citation23	1	0	Tc-99m + ICG
Rubinstein et al, 2014^Citation25	4	0	Tc-99m + ICG
Rubinstein et al, 2015B^Citation34	1	0
Rubinstein et al, 2015A^Citation33	1	0
Motomura et al, 2010^Citation35	1	0	Tc-99m + vital blue
Maalouf et al, 2012^Citation31	2	0	Tc-99m
Schwarz et al, 2008^Citation27	1	0	Tc-99m
Baroody et al, 2004^Citation28	2	2	Tc-99m + lymphazurin blue
Esmaeli et al, 2001^Citation11	1	0	Tc-99m + isosulfan blue
Wilson et al, 2001^Citation36	1	0	Tc-99m

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