Sentinel Lymph Node Biopsy for Cutaneous Head and Neck Melanoma: Mapping the Parotid Gland.
Sentinel lymph node biopsy (SLNB) for primary cutaneous head and neck melanoma (CHNM) has been shown to be successful and is the current standard of care for intermediate-thickness melanoma. We evaluated our experience with CHNM associated with SLNB mapping to the region of the parotid gland.



Retrospective review of a prospectively collected melanoma database identified 1014 CHNMs. Two-hundred twenty-three patients underwent SLNB, and 72 (32%) had mapping in the region of the parotid gland between May 1995 and June 2003.



The mean number of SLNs per patient was 2.5. A sentinel lymph node (SLN) was successfully identified in 94% of patients, and in 12%, the SLN was positive for metastatic disease. Biopsy of intraparotid SLNs was performed in 51.4% and of periparotid SLNs in 26.4%, and a superficial parotidectomy was performed in 22.2%. Ten patients were found to have lymph nodes in the parotid region with metastatic disease (eight identified by SLNB), and two (20%) patients developed intraparotid lymph node recurrence in the setting of a negative SLNB. Same-basin recurrence in SLN-negative patients was 3.3% with a median follow-up of 26 months. Facial nerve dysfunction was identified in seven (10%) patients. Facial nerve function returned to preoperative status in all patients.



SLNB for patients with primary CHNM mapping to the parotid gland can be performed with a high degree of accuracy and a low morbidity consisting of temporary facial nerve paresis.
Picon
Antonio I
AI
Gastric and Mixed Tumors Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, 10021.
Coit
Daniel G
DG
Gastric and Mixed Tumors Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, 10021.
Shaha
Ashok R
AR
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, P.O. Box 285, New York, New York, 10021.
Brady
Mary S
MS
Gastric and Mixed Tumors Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, 10021.
Boyle
Jay O
JO
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, P.O. Box 285, New York, New York, 10021.
Singh
Bhuvanesh B
BB
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, P.O. Box 285, New York, New York, 10021.
Wong
Richard J
RJ
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, P.O. Box 285, New York, New York, 10021.
Busam
Klaus J
KJ
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, 10021.
Shah
Jatin P
JP
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, P.O. Box 285, New York, New York, 10021.
Kraus
Dennis H
DH
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, P.O. Box 285, New York, New York, 10021. krausd@mskcc.org.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002610:Cheek; D004396:Coloring Agents; D004428:Ear Neoplasms / Q000473:pathology*; D005153:Facial Neoplasms / Q000473:pathology*; D005154:Facial Nerve / Q000503:physiopathology; D020220:Facial Nerve Injuries / Q000209:etiology; D005260:Female; D005546:Forehead; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010307:Parotid Neoplasms / Q000556:secondary* / Q000601:surgery; D035421:Parotid Region; D020127:Recovery of Function; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects; D012878:Skin Neoplasms / Q000473:pathology*; D047368:Tumor Burden; D055815:Young Adult
D004396:Coloring Agents