Dilemma of clinically node-negative head and neck melanoma: Outcome of “watch and wait” policy, elective lymph node dissection, and sentinel node biopsy—A systematic review.

Autor: Tanis, Pieter J., Nieweg, Omgo E., van den Brekel, Michiel W. M., Balm, Alfons J. M.
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Zdroj: Head & Neck; Mar2008, Vol. 30 Issue 3, p380-389, 10p, 3 Charts
Abstrakt: Background The management of patients with clinically node-negative melanoma of the head and neck remains controversial. Methods This is a systematic review of management strategies for stage I head and neck melanoma. Results Subgroup analysis of 1 randomized controlled trial (RCT) and most available cohort studies do not reveal a significant impact of elective neck dissection on survival. For 1.2- to 3.5-mm-thick melanoma at all anatomical sites, 1 RCT does not show an overall significant melanoma-specific survival benefit of sentinel node biopsy, but subgroup analysis suggests a survival benefit for lymph node–positive patients, confirming findings from 3 retrospective series. Sentinel node biopsy in the head and neck region can be technically demanding, with lower identification rates and higher false-negative rates. Conclusion There is no conclusive survival advantage of either elective neck dissection or sentinel node biopsy in patients with clinically node-negative head and neck melanoma of intermediate thickness. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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