Kutane maligne Melanome der Kopf-Hals-Region mit intermediärer Tumordicke: die Bedeutung der elektiven Versorgung der Lymphabflusswege im klinischen Stadium I
| Autor: | W. Kehrl, C. Sagowski, F. U. Metternich, K. Neuber, S. Wenzel |
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| Rok vydání: | 2003 |
| Předmět: | |
| Zdroj: | Laryngo-Rhino-Otologie. 82:19-24 |
| ISSN: | 1438-8685 0935-8943 |
| DOI: | 10.1055/s-2003-36906 |
| Popis: | Background At present a tendency towards a more limited surgery in the treatment of clinical stage I and II melanoma exists. The controversy of elective lymph node dissections (ELND) in stage-I-melanoma with intermediate tumor thickness continues to be discussed. The sentinel lymph node biopsy may provide improved staging accuracy. Methods It was the aim of this study to examine whether extent of surgical treatment particularly the ELND in case of intermediate tumor thickness has prognostic significance. Metastatic pattern of these malignant melanoma were analyzed to form a basic for routine sentinel lymph node biopsy. Results No prognostic difference could be shown in clinical stage I melanoma with intermediate tumor thickness between "local excision" (no lymph node dissection) or "wait and see" (delayed lymph node dissection because of clinical suspicion) respectively and "local excision with elective neck dissection". The 5-year survival was 67 %, 67 % and 69 %. It ran to 53 % in case of therapeutical lymph node dissection as primary therapy. Occult nodal metastases occur in 15 % and "skip"-metastases in 6 %. Conclusions No therapeutic value for ELND in clinical stage I malignant melanoma of the head and neck with intermediate tumor thickness could be shown. The low incidence of occult nodal metastases and "skip"-metastases represents the basic for sentinel lymph node biopsy. |
| Databáze: | OpenAIRE |
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