Sentinel Lymph Node Biopsy for Head and Neck Melanomas
| Autor: | Eric Lentsch, Sandra L. Wong, Celia Chao, R. Dirk Noyes, Michael J. Edwards, M. I. Ross, Kelly M. McMasters, Wayne K. Stadelmann, Douglas S. Reintgen |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Skin Neoplasms Adolescent Sentinel lymph node Neoplasm Recurrence Biopsy medicine Humans Radionuclide imaging Prospective Studies Radionuclide Imaging Head and neck Melanoma neoplasms Aged Blue dye medicine.diagnostic_test Sentinel Lymph Node Biopsy business.industry Extremities Middle Aged medicine.disease Facial nerve injury Surgery Oncology Head and Neck Neoplasms Female Lymph Nodes Radiology Neoplasm Recurrence Local business |
| Zdroj: | Annals of Surgical Oncology. 10:21-26 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/aso.2003.06.007 |
| Popis: | Sentinel lymph node (SLN) biopsy for head and neck (HN) melanomas may be more technically challenging compared with other locations because of complex lymphatic drainage patterns. This analysis was performed to compare the results of SLN biopsy for HN, truncal, and extremity melanomas.The Sunbelt Melanoma Trial includes patients aged 18 to 70 with melanomasor = 1.0 mm thick. Statistical comparison was performed by chi2 or analysis of variance test.A total of 2610 patients were evaluated with a median follow-up of 18 months. The mean number of SLN per nodal basin was 2.8, 2.7, and 2.1 for HN, truncal, and extremity melanomas, respectively. Median Clark level, Breslow thickness, and percentage of ulceration were similar between the groups. Peri-parotid SLN was identified in 25% of cases; there were no facial nerve injuries. SLN biopsy for HN melanoma had higher false-negative rates at 1.5% (vs. 0.5% for trunk or extremity) but less histologically positive SLN at 15% (vs. 23.4%, and 19.5%; P.001) compared with truncal and extremity melanoma. Blue dye was visualized less frequently in SLN of HN melanoma patients compared with those with trunk or extremity melanomas.Preoperative lymphoscintigraphy and meticulous intraoperative search for blue/radioactive nodes may improve results in HN melanomas. |
| Databáze: | OpenAIRE |
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