title: Lymphoscintigraphy with intraoperative gamma probe sentinel node detection: clinical impact in patients with head and neck melanomas.
abstract: OBJECTIVE
  The aims of this paper were to evaluate the clinical relevance of lymphoscintigraphy with intraoperative gamma-probe detection in identifying sentinel nodes (SNs) and to study the prognostic value of SN biopsy in head and neck melanoma patients.
  
  
  METHODS
  Sixty-one patients had lymphoscintigraphy with intradermal injections of 99mTc-Nanocoll (40 MBq), 24 h before surgery. Tumor-positive SNs patients underwent total lymph node dissection. Postoperative histological examination was performed. Patients were followed up for 1 to 5 years (median 3 years). The tumor relapses and the overall survival were evaluated by means of statistical methods.
  
  
  RESULTS
  Lymphoscintigraphy showed lymphatic distribution to more than one basin in 45 patients (74%), in 15 patients one basin was visualized and no basin in 1 patient. In 41 patients the SN was negative for metastases, while in 20 was positive. In a high percentage of patients (30%), metastatic involvement occurred in more than one lymph node basin. During follow-up in the negative SN group, 40 patients remained disease free and 1 relapsed. In the positive SN group, 10 patients remained disease free and 10 relapsed. Recurrence time ranged from 6 to 11 months. The overall survival of the SNs negative group was significantly higher than the positive SN group.
  
  
  CONCLUSIONS
  This approach was able to distinguish: a) patients with tumor-negative SNs with a favorable clinical course (98% did not relapse, P<0.001); b) patients with tumor-positive SNs with a high rate of tumor relapse (50%, P<0.001). Therefore SN biopsy may give information about prognosis in head and neck melanoma patients.
authors.affiliation: Nuclear Medicine Division, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Maccauro
authors.forename: C
authors.initials: C
authors.lastname: Villano
authors.forename: G
authors.initials: G
authors.lastname: Aliberti
authors.forename: L
authors.initials: L
authors.lastname: Ferrari
authors.forename: M R
authors.initials: MR
authors.lastname: Castellani
authors.forename: R
authors.initials: R
authors.lastname: Patuzzo
authors.forename: D
authors.initials: D
authors.lastname: Tshering
authors.forename: M
authors.initials: M
authors.lastname: Santinami
authors.forename: E
authors.initials: E
authors.lastname: Bombardieri
mesh_terms: D000328:Adult; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; 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; D011877:Radionuclide Imaging / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid