Sentinel Lymphadenectomy in Cutaneous Melanoma
Autor: | G. Tipaldi, N. De Liguori Carino, Sergio Chimenti, Oreste Claudio Buonomo, Cu Casciani, Mario Roselli, A. Felici, R. Piccirillo, Chiara Cipriani, S. Mariotti, Fiorella Guadagni, Valerio Cervelli, Augusto Orlandi, Alessandra Vittoria Granai |
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Rok vydání: | 2002 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Skin Neoplasms Adolescent Settore MED/06 - Oncologia Medica medicine.medical_treatment Sentinel lymph node 030218 nuclear medicine & medical imaging Metastasis Breslow Thickness 03 medical and health sciences 0302 clinical medicine medicine Humans Radionuclide Imaging Technetium Tc 99m Aggregated Albumin Melanoma Lymph node Aged Sentinel Lymph Node Biopsy business.industry General Medicine Middle Aged medicine.disease Surgery Settore MED/18 - Chirurgia Generale medicine.anatomical_structure Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis Cutaneous melanoma Radiopharmaceuticals Lymph Node Excision Lymph Nodes Female Immunohistochemistry Lymphadenectomy Radiology business |
Zdroj: | Europe PubMed Central Scopus-Elsevier |
ISSN: | 2038-2529 0300-8916 |
Popis: | Aims and Background In the last ten years validation of the sentinel lymph node (SLN) concept has led to modification of the surgical approach for patients with intermediate-risk cutaneous melanoma. Methods and Study Design Forty-eight patients affected by cutaneous melanoma with a Breslow thickness between 0.65 and 4 mm were enrolled in the study. Approximately 2 mCi of radiotracer and 1 mL of vital blue dye were injected in each patient around the site of the primary lesion. Lymphoscintigraphy was performed until the lymphatic basin and the respective SLN were localized. The whole surgical procedure consisted of enlargement of the surgical margins followed by localization and excision of the SLN(s) by using both radiotracer and vital dye. Whenever the SLN proved to be histologically positive for metastasis, complete regional lymphadenectomy was performed. Results Within 15 minutes of radiotracer administration the lymphatic basin was localized in all 48 patients by lymphoscintigraphy. Vital dye and radiotracer successfully allowed SLN localization and excision in 46 of 48 patients (97%); in one case the SLN was detected by radiotracer alone. The SLN proved to be metastatic in six (13%) of 46 evaluable patients; interestingly, in three of them the presence of metastatic cells was revealed only by immunohistochemistry. All patients with tumor-positive SLNs had primary lesions with a Breslow thickness = 2 mm. Conclusions Sentinel lymphadenectomy is able to identify lymph node involvement in patients with cutaneous melanoma with a Breslow thickness >1 mm, thus avoiding the risks associated with radical regional lymphadenectomy. Lymphoscintigraphy proved to be an important tool to obtain correct preoperative localization of the drainage basin, especially for melanomas located on the face and trunk. |
Databáze: | OpenAIRE |
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