Complete lymphadenectomy following positive sentinel lymph node biopsy in cutaneous melanoma: a critical review

Autor: Daniel Eiger, Daniel Arcuschin de Oliveira, Renato Leão de Oliveira, Murilo Costa Sousa, Mireille Darc Cavalcante Brandão, Renato Santos de Oliveira Filho
Jazyk: English<br />Portuguese
Rok vydání: 2018
Předmět:
Zdroj: Anais Brasileiros de Dermatologia, Vol 93, Iss 4, Pp 553-558 (2018)
Druh dokumentu: article
ISSN: 0365-0596
1806-4841
DOI: 10.1590/abd1806-4841.20187312
Popis: Abstract: Cutaneous melanoma is the solid neoplasia with the highest growing incidence among all tumors. It spreads predictably to the lymphatic vessels and sentinel lymph node, and when the latter is affected the prognosis worsens dramatically. Sentinel lymph node biopsy is considered when thickness of the primary tumor exceeds 1mm and/or when there are adverse features in thinner melanomas. When there is nodal metastasis, current evidence in the literature recommends complete lymphadenectomy, although this procedure has its intrinsic risks (i.e., lymphedema and cellulitis), and there are no published clinical trials proving additional overall survival benefits. The current in-depth literature review thus aims to identify patients that will benefit most from the procedure, including those with the highest likelihood of presenting additional affected lymph nodes in the same nodal basin. The authors also discuss techniques for identification of the sentinel lymph node, false-negative rates, and predictive models for lymph node involvement. In conclusion, complete elective lymphadenectomy should always be discussed on a case-by-case basis when metastases are detected in the sentinel lymph node.
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