Sentinel lymph node biopsy for cutaneous head and neck melanomas.
Arch Otolaryngol Head Neck Surg
; 128(3): 285-91, 2002 Mar.
Article
em En
| MEDLINE
| ID: mdl-11886345
ABSTRACT
OBJECTIVE:
To report the results of sentinel lymph node biopsy (SLNB) for cutaneous head and neck melanomas (CMHNs).DESIGN:
Consecutive series followed for a median of 20 months.SETTING:
Tertiary cancer care center. PATIENTS Fifty-six individuals with clinically node-negative CMHN, median Breslow thickness, 2.6 mm (range, 0.2-20.0 mm).INTERVENTIONS:
Preoperative technetium 99m sulfur colloid lymphoscintigraphy (PLSG) followed within 4 hours by intraoperative handheld gamma probe localization (IHGP). Intraoperative injection of 1% isosulfan blue dye (IBD) was used in 48 patients. Immediate completion nodal dissection was performed for metastatic SLNs on intraoperative frozen section analysis and monitoring for negative SLNs. MAIN OUTCOMEMEASURES:
Rate of SLN identification, SLN and non-SLN positivity, same-basin recurrence, and disease-specific and recurrence-free survival.RESULTS:
Combination of IHGP and IBD improved SLN identification to 96% from 93% for IHGP and 73% for IBD alone. Four patients had a positive SLN on frozen section analysis. A negative SLNB correctly predicted regional nodal control in 47 of 48 patients but missed 1 of 5 patients who had regional lymphatic disease. All 4 patients who failed SLNB remain alive and free of recurrent disease. Two-year Kaplan-Meier disease-specific and relapse-free survival was 91% and 88%, respectively. Two-year disease-specific survival was 93% for SLN-negative patients and 50% for SLN-positive patients (P=.20).CONCLUSIONS:
Combining PLSG with IHGP and IBD improves the success rate of SLNB. Although SLNB is a reliable indicator of the status of the draining lymphatic basins in CMHN, patients with negative SLNs must be observed for longer periods to understand the true implications of the procedure.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Cutâneas
/
Biópsia de Linfonodo Sentinela
/
Neoplasias de Cabeça e Pescoço
/
Melanoma
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Otolaryngol Head Neck Surg
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2002
Tipo de documento:
Article
País de afiliação:
Estados Unidos