1032 Sentinel Lymph Node Biopsy for Malignant Melanoma: An Audit Assessing Departmental Compliance with National Guidelines

Aim To investigate and improve local departmental compliance with the current NICE Guidelines (2022) on sentinel lymph node biopsy (SLNB) for malignant melanoma (MM). Method Two consecutive audit cycles of all patients undergoing SLNB for MM: Cycle A (1st June-22nd August 2023) and Cycle B (1st September–31st November 2023). Data collected from electronic records (Pathpoint/Cerner), including demographics; T-stage; Breslow Thickness; lymphovascular invasion (LVI); mitotic index; ulceration; intraoperative SNLB assessment and sentinel lymph node positivity. Results of Cycle A were delivered to the department prior to Cycle B. Exclusion criteria: SLNB not for MM (e.g., breast cancer), nodal clearance. Results Cycle A: 35 patients included: 20 Females + 15 Males, aged 33–80 years (Mean 62.26 years). Cycle B: 42 patients included: 15 Females + 27 Males, aged 25–88 years (Mean 60.0 years). Cycle B summary: 3/42 (7.1%) – no clear indication for SLNB (8.6% Cycle A) 0/42 (0%) - no T stage documented (0% Cycle A) 0/42 (0%) - no Breslow Thickness documented (2.9% Cycle A) 4/42 (9.5%) - no LVI documented (14.3% Cycle A) 4/42 (9.5%) - no mitotic index documented (14.3% Cycle A). Conclusions Our department demonstrated successful compliance with NICE guidelines on SLNB for melanoma at 92.6% in Cycle B (91.4% in Cycle A). Documentation of preoperative staging, Breslow Thickness and intraoperative narrative was also satisfactory at 100% for both cycles. Further work is required to ensure histology findings (Ulceration, Mitotic Index & LVI) and node appearance is accurately documented.