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Interval Sentinel Lymph Nodes With the Use of Routine Lymphoscintigraphy in Extremity Melanoma.
West, Natalie J; Wadhwa, Shruti; Ayars, Carter; Philips, Prejesh; Martin, Robert C G; Scoggins, Charles R; McMasters, Kelly M; Egger, Michael E.
Afiliação
  • West NJ; The Hiram C Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.
  • Wadhwa S; The Hiram C Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.
  • Ayars C; The Hiram C Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.
  • Philips P; The Hiram C Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.
  • Martin RCG; The Hiram C Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.
  • Scoggins CR; The Hiram C Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.
  • McMasters KM; The Hiram C Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.
  • Egger ME; The Hiram C Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky. Electronic address: michael.egger@louisville.edu.
J Surg Res ; 293: 613-617, 2024 01.
Article em En | MEDLINE | ID: mdl-37837816
ABSTRACT

INTRODUCTION:

Lymphoscintigraphy (LS) helps identify drainage to interval (epitrochlear or popliteal) lymph node basins for extremity melanomas. This study evaluated how often routine LS evaluation identified an interval sentinel lymph node (SLN) and how often that node was found to have metastasis.

METHODS:

A single institution, retrospective study identified patients with an extremity melanoma who underwent routine LS and SLN biopsy over a 25-y period. Comparisons of factors associated with the identification of interval node drainage and tumor status were made.

RESULTS:

In 634 patients reviewed, 5.7% of patients drained to an interval SLN. Of those biopsied, 29.2% were positive for micrometastases. Among patients with biopsies of both the traditional and interval nodal basins, nearly 20% had positive interval nodes with negative SLNs in the traditional basin. Sex, age, thickness, ulceration, and the presence of mitotic figures were not predictive of identifying an interval node on LS, nor for having disease in an interval node. Anatomic location of the primary melanoma was the only identifiable risk factor, as no interval nodes were identified in melanomas of the thigh or upper arm (P ≤ 0.001).

CONCLUSIONS:

Distal extremity melanomas have a moderate risk of mapping to an interval SLN. Routine LS should be considered in these patients, especially as these may be the only tumor-positive nodes. However, primary extremity melanomas proximal to the epitrochlear or popliteal nodal basins do not map to interval nodes, and improved savings and workflow could be realized by selectively omitting routine LS in such patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Linfonodo Sentinela / Linfadenopatia / Melanoma Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Linfonodo Sentinela / Linfadenopatia / Melanoma Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article