Minimal-access surgery for staging of malignant melanoma.
Arch Surg
; 130(6): 654-8; discussion 659-60, 1995 Jun.
Article
en En
| MEDLINE
| ID: mdl-7539252
ABSTRACT
OBJECTIVE:
To develop a simple, minimally invasive technique of determining whether regional node metastasis has occurred in patients with melanoma.SETTING:
Teaching hospital tertiary care and private practice settings. PATIENTS Between February 1993 and October 1994, 121 patients with invasive malignant melanoma and clinically negative lymph nodes were enrolled in this clinical trial.DESIGN:
Consecutive sample clinical trial. Within 24 hours prior to lymph node resection, a radioactive tracer was injected into the dermis around the site of the primary melanoma. Forty-four patients also had blue dye injected immediately prior to surgical resection. Measurement of radioactivity in the lymph nodes and surgical localization were made using a handheld gamma detector. Radiolabeled nodes were selectively removed with the least dissection possible. In patients with pathologically positive radiolabeled nodes, regional lymphadenectomy was performed. OUTCOMEMEASURES:
Successful identification of radiolabeled sentinel lymph nodes, correlation of radiolabeling with injection of blue dye, and regional node recurrence rate.RESULTS:
Surgeons successfully resected the radiolabeled sentinel lymph nodes in 118 (98%) of 121 patients. One hundred percent of blue-stained lymph nodes were successfully radiolabeled. Fifteen patients had pathologically positive sentinel lymph nodes. In 10 patients, the sentinel node was the only node with metastasis. Two systemic and one regional node recurrences occurred during a mean follow-up of 220 days.CONCLUSIONS:
Selective gamma probe-guided resection of the radiolabeled sentinel lymph node is possible in over 95% of patients with melanoma. This technique offers a simple and reliable method of staging of regional lymph nodes in these patients without performing a regional lymphadenectomy.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Melanoma
/
Estadificación de Neoplasias
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Humans
/
Middle aged
Idioma:
En
Revista:
Arch Surg
Año:
1995
Tipo del documento:
Article
País de afiliación:
Estados Unidos