BackgroundThe use of sentinel lymph node biopsy (SLNB) in the older population, defined as those over 70 years old, has been debated since the adoption of SLNB into routine practice. Interestingly, there remains a paucity of evidence, especially regarding the rates of SLNB positivity, complications, and subsequent adjuvant therapy in those with node positivity.MethodData on patient's comorbidities, positivity rates, complication rates, and subsequent adjuvant treatments were collected prospectively from 998 patients (644 patients < 70 and 354 patients ≥ 70 years old) between 2016 and 2022.ResultsPatients aged ≥ 70 were found to have a higher prevalence of comorbidities, including hypertension, diabetes and hyperlipidaemia. The mean Breslow thickness was 2.2 and 2.5 in the under and over 70 groups respectively (p = 0.03). The mean mitotic rate was found to be 3.3 in the under 70 s and 4.1 in the over 70 s (p = 0.02). Despite these results, no significant differences were observed in the positivity rates of sentinel lymph node biopsies or in the treatment options selected for positive results. The under 70 s were more likely to experience loss of sensation (p < 0.01), but no difference was found in the total number of complications between the two groups.ConclusionAlthough patients aged 70 and above had a greater incidence of comorbidities, the study revealed that they had lower complications rates and there was no significant variation in the SLNB positivity rate or chosen treatment options between the two age groups. This study supports the move to physiological rather than chronological age assessments in SLNB of the elderly.

中文翻译：

---

老年人黑色素瘤前哨淋巴结活检：结果的前瞻性分析

背景自从将前哨淋巴结活检 (SLNB) 纳入常规实践以来，在老年人群（定义为 70 岁以上的人群）中使用前哨淋巴结活检 (SLNB) 一直存在争议。有趣的是，仍然缺乏证据，特别是关于淋巴结阳性患者的 SLNB 阳性率、并发症和后续辅助治疗。方法前瞻性地从 998 名患者中收集了有关患者合并症、阳性率、并发症率和后续辅助治疗的数据2016年至2022年间（644名<70岁患者和354名≥70岁患者）。结果发现≥70岁患者的合并症患病率较高，包括高血压、糖尿病和高脂血症。70 组以下和 70 组以上组的平均 Breslow 厚度分别为 2.2 和 2.5（p= 0.03）。70 岁以下的平均有丝分裂率为 3.3，70 岁以上的平均有丝分裂率为 4.1（p= 0.02）。尽管有这些结果，但前哨淋巴结活检的阳性率或为阳性结果选择的治疗方案没有观察到显着差异。70 岁以下的人更有可能出现感觉丧失的情况（p< 0.01），但两组之间的并发症总数没有差异。结论虽然70岁及以上患者合并症发生率较高，但研究显示他们的并发症发生率较低，且并发症发生率无显着差异。两个年龄组之间的 SLNB 阳性率或选择的治疗方案。这项研究支持在老年人的前哨淋巴结活检中转向生理年龄而不是实际年龄评估。