Selective lymph node dissection in patients with intermediate thickness melanoma: our experience.
The role of elective lymph node dissection (ELND) for the treatment of cutaneous melanoma has been debated for many years. Actually, the value of ELND is seriously questioned because an increasing of overall survival rates has not been demonstrated. The lymphatic mapping technique, initially performed by an intradermic injection of vital blue dye, subsequently improved by the use of radioguided surgery (RGS), proved effective for the detection of clinical occult lymph node metastasis. We performed a sentinel node biopsy on 71 patients with stage pT2/T3N0M0 melanoma. Vital blue dye mapping alone was performed on 39 patients; the remaining 32 patients had a combined lymphatic mapping with both blue dye and RGS. The sentinel node (SN) was complexively identified in 69/71 (97.2%) patients. Sixteen patients (23.2%) were found to have metastatic melanoma cells in their SN(s); all these patients underwent lymph node dissection of the affected basin. Our experience confirmed that the intraoperative detection of sentinel nodes using both blue dye and radio-guided surgery is an effective and reliable technique for selecting patients to be submitted to lymph node dissection.
Cafiero
F
F
Department of Surgical Oncology, University of Genoa, Italy.
Peressini
A
A
Percivale
P L
PL
Rainero
M L
ML
Faggioni
M
M
Gipponi
M
M
Queirolo
P
P
Nicolo
G
G
Bertoglio
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D004396:Coloring Agents; D017558:Elective Surgical Procedures; D004801:Eosine Yellowish-(YS); D005069:Evaluation Studies as Topic; D005260:Female; D005629:Frozen Sections; D006416:Hematoxylin; D006801:Humans; D007150:Immunohistochemistry; D007430:Intraoperative Care; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000737:chemistry / Q000473:pathology / Q000601:surgery*; D058950:Melanoma-Specific Antigens; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D009367:Neoplasm Staging; D015642:Radiology, Interventional; D011877:Radionuclide Imaging; D012394:Rosaniline Dyes; D009418:S100 Proteins / Q000032:analysis; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology / Q000601:surgery*; D013194:Staining and Labeling; D013668:Technetium Tc 99m Aggregated Albumin
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D004396:Coloring Agents; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins; D012394:Rosaniline Dyes; D009418:S100 Proteins; D013668:Technetium Tc 99m Aggregated Albumin; C008769:sulfan blue; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin