Reliability of sentinel lymph-node extirpation as a diagnostic method for malignant melanoma of the head and neck region.
A series of 106 patients with malignant melanoma of the head and neck and clinically negative local lymph-node status were included in a multimodal therapy programme and underwent sentinel lymph-node extirpation in 1999-2003. Out of 246 preoperatively marked lymph nodes, only 172 (70%) were identified intraoperatively and removed. In 89% of all patients at least one sentinel lymph node was removed. Histological examination revealed metastases in the sentinel lymph nodes of 17 patients. In the mean follow-up period of 47 months (range 4-76 months), regional lymph-node metastases were found in another eight patients. The non-marked lymph nodes that were often removed at the same time, in an elective cervical lymph-node dissection, did not reveal any metastasis in any of the cases where the sentinel lymph nodes were negative. The sensitivity of sentinel lymph-node extirpation was influenced by the length of the follow-up period and the detection rate, and was 68% (17/17+8), a result superior to that of any other diagnostic tool. Sentinel lymph-node extirpation is a valuable method in addition to elective lymph-node dissection.
Teltzrow
T
T
Fachklinik Hornheide, Dorbaumstr. 300, 48157 Münster, Germany. Teltzrow@online.de
Osinga
J
J
Schwipper
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005188:False Negative Reactions; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging / Q000601:surgery; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*