[Anatomical location of the primary tumor as a variable to be considered in sentinel node biopsy of cutaneous melanoma].
BACKGROUND
The anatomical location of cutaneous melanoma has been suggested to be an independent prognostic factor. The aim of the present study was to determine whether the location of the primary tumor influences sentinel node detection in cutaneous melanoma.


METHODS
Two hundred twelve patients with primary cutaneous melanoma (96 of the limbs, 89 of the trunk and 27 of the head or neck) who underwent sentinel lymph node biopsy were studied. Adequate lymphoscintigraphic and surgical localization was evaluated and epidemiological and histopathological variables, the number of lymph nodes draining the site of the primary lesion, sentinel nodes per drainage basin, and tumor-positive nodes were compared.


RESULTS
Localization was less successful for tumors of the head and neck (88.8%), both with lymphoscintigraphy (P<.001) and surgery (P<.0005), especially for lymph nodes adjacent to salivary glands (P<.0005). Melanomas of the trunk showed a greater number of nodes per lesion and wider variability in drainage pathways (P<.0005), although there were no differences in the number of sentinel nodes per drainage basin (P=.455).


CONCLUSIONS
Sentinel node detection with less successful in cutaneous melanomas located in the head and neck. Location of the sentinel node adjacent to a salivary gland is a factor that influences its detection. Cutaneous melanomas of the trunk showed a higher number of draining nodes per lesion than those located in the limbs or head and neck.
Piñero-Madrona
Antonio
A
Servicio de Cirugía General, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. apm.cg@ono.com
Martínez-Escribano
Jorge
J
Nicolás-Ruiz
Francisco
F
Martínez-Barba
Enrique
E
Canteras-Jordana
Manuel
M
Rodríguez-González
José Manuel
JM
Sánchez-Pedreño
Paloma
P
Frías-Iniesta
Jose
J
Parrilla-Paricio
Pascual
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009333:Neck; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*; D013909:Thorax