MAR 21, 2013
By Matthew W. Wilson, MD, FACS
Ocular Pathology/Oncology
The authors performed a literature review in order to describe the current indications, methods and outcomes of sentinel lymph node biopsy (SLNB) for eyelid and conjunctival tumors. They found that false negative biopsy rates appear to be decreasing as more experience is gained with the technical nuances of the procedure. Reported complications are low. They conclude that SLNBs are feasible and provide important information for staging affected patients.
The principal indications were conjunctival melanomas ≥ 2mm in thickness and/or histologic evidence of ulceration; cutaneous melanomas of the eyelid ≥ 1 mm in thickness, those with > 1 mitotic figure per high-power field, and/or those with histologic evidence of ulceration; sebaceous carcinomas ≥ 10 mm in width; and any Merckel cell carcinoma.
They recommend continued follow-up of all patients with high-risk conjunctival and eyelid malignancies, regardless of sentinel lymph node status at the time of biopsy.
They say that future multi-institutional trials are needed to expand on currently available data, fine-tune patient selection criteria, and elucidate the relationships between sentinel lymph node status and patient survival and tumor recurrence.