Technologic (r)evolution leads to detection of more sentinel nodes in patients with melanoma in the head and neck region

Autor: Bernies van der Hiel, Fijs Van Leeuwen, Lenka Vermeeren, W. Martin C. Klop, Vincent van der Noort, Nynke S. van den Berg, Baris Karakullukcu, Tessa Buckle, Bart A. van de Wiel, Renato A. Valdés Olmos, Oscar R. Brouwer, Gijs H. KleinJan, Alfons J. M. Balm, Danique M.S. Berger, Michiel W. M. van den Brekel, Omgo E. Nieweg
Přispěvatelé: Oral and Maxillofacial Surgery, Maxillofacial Surgery (AMC), Maxillofacial Surgery (VUmc)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: J Nucl Med
Berger, D M S, van den Berg, N S, van der Noort, V, van der Hiel, B, Valdés Olmos, R A, Buckle, T, KleinJan, G H, Brouwer, O R, Vermeeren, L, Karakullukçu, B, van den Brekel, M W M, van de Wiel, B A, Nieweg, O E, Balm, A J M, van Leeuwen, F W B & Klop, W M C 2021, ' Technologic (r)evolution leads to detection of more sentinel nodes in patients with melanoma in the head and neck region ', The Journal of Nuclear Medicine, vol. 62, no. 10, pp. 1357-1362 . https://doi.org/10.2967/jnumed.120.246819
Journal of nuclear medicine, 62(10). Society of Nuclear Medicine Inc.
Journal of Nuclear Medicine, 62(10), 1357-1362. SOC NUCLEAR MEDICINE INC
The Journal of Nuclear Medicine, 62(10), 1357-1362. Society of Nuclear Medicine Inc.
ISSN: 0161-5505
DOI: 10.2967/jnumed.120.246819
Popis: Background: Sentinel lymph node (SN) biopsy (SLNB) has proven to be a valuable tool for staging melanoma patients. Since its introduction in the early 1990s, this procedure has undergone several technological refinements, including the introduction of single photon emission computed tomography combined with computed tomography (SPECT/CT) as well as radio- and fluorescence-guidance. The purpose of the current study was to evaluate the effect of this technological evolution on SLNB in the head and neck region. Primary endpoint was the false-negative (FN) rate. Secondary endpoints were number of harvested SNs, overall operation time, operation time per harvested SN and postoperative complications. Patients and Methods: A retrospective database was queried for cutaneous head and neck melanoma patients who underwent SLNB at The Netherlands Cancer Institute between 1993 and 2016. The implementation of new detection techniques was divided in 4 groups: (1) 1993-2005, with preoperative lymphoscintigraphy and intraoperative use of both a gamma ray detection probe and patent blue (n = 30); (2) 2006-2007, with addition of preoperative roadmaps based on SPECT/CT (n = 15); (3) 2008-2009, with intraoperative use of a portable gamma camera (n = 40); and (4) 2010-2016, with the addition of near-infrared fluorescence guidance (n = 192). Results: A total of 277 patients were included. At least one SN was identified in all patients. A tumor-positive SN was found in 59 patients (21.3%), 10 in group 1 (33.3%), 3 in group 2 (20.0%), 6 in group 3 (15.0%) and 40 in group 4 (20.8%). Regional recurrences of patients with tumor-negative SNs resulted in an overall FN rate of 11.9% (FN groups 1: 16.7%; 2: 0%; 3: 14.3%; 4: 11.1%). The number of harvested nodes increased with advancing technologies (P = 0.003) whereas Breslow thickness and operation time per harvested SN decreased (P = 0.003 and P = 0.017, respectively). There was no significant difference in percentage of tumor-positive SNs, overall operation time and complication rate between the different groups. Conclusion: The use of advanced detection technologies led to a higher number of identified SNs without increase in overall operation time, which may indicate an improved surgical efficiency. Operation time per harvested SN decreased, the average FN rate remained 11.9% and unchanged over 23 years. There was no significant change in postoperative complication rate.
Databáze: OpenAIRE
Externí odkaz: