Abstract: Background and purpose: Malignant melanoma has become one of the most rapidly increasing malignant diseases in China. Sentinel lymph node biopsy (SLNB) was conducted as a standard surgical procedure for cutaneous melanoma in Western world but not in China nowadays. Compared with those in Western country, Chinese melanomas are characterized by the presence of more acral lesions, thick invasion and high prevalence of ulceration with a poor prognosis. Prognosis of Chinese melanoma after surgery remains unclear. This study aimed to collect clinical data of Chinese melanoma patients so as to evaluate the accessibility of SLNB and summarize the survival outcomes. Methods: Histologically diagnosed primary melanoma with no clinical evidence of local lymph node and distant metastasis, was retrospectively collected from 2009 to 2017 in Fudan University Shanghai Cancer Center. With wide resection of the primary lesion, SLNB was routinely performed in each case. Isotopic tracing or methylene blue dye was applied for identification of the sentinel lymph node (SLN). Follow-ups were taken afterwards. Results: Totally 452 patients were included. The mean Breslow thickness was 3.29 mm with 66.4% acral lesion and 59.7% ulceration. The sentinel lymph node positive rate was 26.8%. Including 4% false-negative rate, the overall lymph node metastatic rate was 30.8%。Five-year overall survival (OS) and disease-free survival (DFS) rate were 66.6% and 55.8%, respectively. SLN status was significantly associated with patients’ outcome. Prognostic analysis showed that Breslow thickness was the independent prognostic factor for SLN metastasis. And SLN status was strongly associated with overall outcomes. Conclusion: SLNB should be employed as a routine surgical procedure for Chinese melanoma with no clinical evidence of metastasis. SLN status is statistically relevant to patient’s disease relapse and overall survival. SLNB can improve the outcome of patients with node micro-metastasis and more importantly provides accurate staging information.

Key words: Acral melanoma, Sentinel node biopsy, Prognosis