Vital dye is enough for inguinal sentinel lymph node biopsy in melanoma patients.
OBJECTIVE
The importance of gamma probe detection (GPD) combined with vital dye for sentinel node (SN) biopsy is well accepted. We evaluated the efficacy of patent blue dye (PBD) in identifying inguinal SN.


METHODS
Ninety-four cutaneous melanoma patients with inferior extremity lesions were submitted to SNB according to a established protocol. Patients were randomized in two groups: Blue group, where SN was identified by PPD and Probe group, where SN was identified by GPD. The median age was 44.2 years and median Breslow thickness was 2.1 mm. Preoperative lymphoscintigraphy, lymphatic mapping with PBD and intra-operative GPD was performed on all patients. Histological examination of SN consisted of hematoxylin-eosin and immunohistochemical staining. If micrometastases were present complete lymphadenectomy was performed. The SN was considered as identified by PBD if it was blue and identified by GPD if it demonstrated at least ten times greater radioactivity than background.


RESULTS
It was explored 94 inguinal lymphatic basins, 145 SN were excised (70 guided primarily by blue dye and 75 guided primarily by probe). All SN identified by preoperative lymphoscintigraphy were excised. In the Blue group PPD identified all SN and all of them were hot. In the Probe group all SN were identified by probe and were blue. The coincidence of PPD and GPD was 100%.


CONCLUSIONS
Patent blue dye is enough to identify superficial inguinal SN in cutaneous melanoma.
Division of Plastic Surgery, Sao Paulo Federal University, Paulista Medical School, Sao Paulo, Brazil. renato.dcir@unifesp.epm.br
Renato Santos de
RS
Oliveira Filho
Allisson Monteiro da
AM
Silva
Bernardo
B
Hochman
Renato Leão de
RL
Oliveira
Liliana
L
Arcuschin
Jairo
J
Wagner
Lílian Yuri
LY
Yamaga
Lydia Masako
LM
Ferreira
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D011300:Preoperative Care; D011877:Radionuclide Imaging; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*
D004396:Coloring Agents; D012394:Rosaniline Dyes; C008769:sulfan blue