title: Superficial femoral lymph node dissection after positive sentinel lymphadenectomy for early-stage melanoma of the lower extremity.
abstract: The purpose of this study was to evaluate retrospectively the value of a subsequent superficial femoral lymph node dissection for patients with early melanoma of the lower extremity after a positive sentinel lymphadenectomy. During a 6-year period at the H. Lee Moffitt Cancer Center & Research Institute, 16 consecutive patients with clinical stage I or stage II melanoma of the lower extremity underwent subsequent superficial femoral lymph node dissections after positive sentinel lymphadenectomies and wide local excisions of the primary lesions. Fifteen patients (94%) were found to have no additional positive lymph nodes from their superficial femoral lymph node dissection specimens. In contrast, only 1 patient (6%) with a thick primary lesion (7.5 mm) was found to have one additional positive lymph node on a subsequent superficial femoral lymph node dissection. No patients developed any regional nodal recurrences during a mean follow-up of 31.1 months (range, 3-80 months). This preliminary report suggests that the majority of the time the sentinel lymph node may be the only site of regional microscopic nodal disease and that a subsequent superficial femoral lymph node dissection may not be necessary in patients with early melanoma of the lower extremity after a positive sentinel lymphadenectomy. However, whether the sentinel lymphadenectomy can be used solely as a regional surgical treatment for this subgroup of patients still warrants further evaluation.
authors.affiliation: Division of Plastic Surgery, University of South Florida and the Cutaneous Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
authors.forename: Lee L Q
authors.initials: LL
authors.lastname: Pu
authors.forename: C Wayne
authors.initials: CW
authors.lastname: Cruse
authors.forename: Karen E
authors.initials: KE
authors.lastname: Wells
authors.forename: Alan R
authors.initials: AR
authors.lastname: Shons
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Reintgen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006119:Groin; D006801:Humans; D007866:Leg; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*