Sentinel node biopsy for melanoma: a study of 241 patients.
The aim of this study was to evaluate the sentinel node biopsy (SNB) technique for melanoma using both radiocolloid and blue dye in 241 clinically N0 patients with melanomas >1.0 mm, or thinner lesions exhibiting regression/ulceration. We showed that an increase in injected radioactivity increased both the number of visualized nodes at lymphoscintigraphy and the number of SNs removed surgically. At least one SN was removed in 98% (236) of patients, and all nodes were identified with the probe. Seventy-four per cent of the 194 patients injected with blue dye had stained SNs. In 46% (144) of the lymph node basins, there was a discrepancy between the nodes visualized at lymphoscintigraphy and the nodes removed at surgery. There were 38 unusually located nodes. Only eight of these were removed surgically; none contained metastases. SN metastases were detected in 22% (53) of patients. There were nine haematoxylin and eosin (HE)-negatives, all of which were found by immunohistochemistry. The false negative rate for the SNB procedure was 4% (2/55). The complication rate was 6% after SNB and 29% after complete node dissection. In conclusion, SN status is a strong prognostic factor in melanoma patients, and SNB has made the approach to radical lymphadenectomy more rational.
Chakera
Annette Hougaard
AH
Department of Plastic Surgery and Burn Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen Ø, Denmark. hougaard_jensen@hotmail.com
Drzewiecki
Krzysztof Tadeusz
KT
Eigtved
Annika
A
Juhl
Birgitte Ravn
BR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary; D015996:Survival Rate; D013668:Technetium Tc 99m Aggregated Albumin; D013671:Technetium Tc 99m Sulfur Colloid
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D013671:Technetium Tc 99m Sulfur Colloid