[Surgical treatment of melanoma: role of the sentinel lymph node].
The aim of this study was to evaluate the surgical therapy of melanoma of the head, neck, trunk or extremities, and the reliability of sentinel node biopsy. Forty-nine patients, 23 men and 26 women, mean age 59 (range: 22-89) years, with melanoma of the skin--the sites affected were the head and neck (7), trunk (17), upper extremities (8) and lower extremities (17)--and clinically negative lymph nodes, participated in the study from January 2000 to December 2002. The mean Breslow thickness was 2.1 mm, and the median thickness 2 mm. Preoperative dynamic and static lymphoscintigraphy, intraoperative blue dye and a gamma-ray detection probe were used. If the histological examination with haematoxylin and eosin revealed metastases, therapeutic lymph-node dissection was performed. Sentinel nodes were identified by lymphoscintigraphy in 47 patients (96%); 82 sentinel nodes (mean 1.65 per patient) were removed from 56 lymph-node stations. Four patients had tumour-positive sentinel nodes. During follow-up, nodal recurrence in a sentinel-node-negative station was documented in 1 patient. Melanoma of the skin can be safely excised with 1-2 cm margins. Therapeutic lymph-node dissection is performed only in node-positive patients. Sentinel-node biopsy allows accurate staging and yields important prognostic information.
Marrazzo
Antonio
A
Dipartimento di Scienze Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Unità Operativa di Chirurgia Oncologica, Casa di Cura ad Alta Specialità Oncologica La Maddalena, Palermo.
Cardinale
Giovanni
G
Noto
Antonio
A
Casà
Luigi
L
Taormina
Pietra
P
Barbera
Gilda
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*