The role of sentinel lymph node biopsy for thin cutaneous melanomas of the head and neck.
From 18% to 35% of cutaneous melanomas are located in the head and neck, and nearly 70% are thin (Breslow thickness ≤ 1 mm). Sentinel lymph node biopsy (SLNB) has an established role in staging of intermediate-thickness melanomas, however its use in thin melanomas remains controversial. In this article, we review the literature regarding risk factors for occult nodal metastasis in thin cutaneous melanoma of the head and neck (CMHN). Based on the current literature, we recommend SLNB for all lesions with Breslow thickness ≥ 0.75 mm, particularly when accompanied by adverse features including mitotic rate ≥ 1 per mm(2), ulceration, and extensive regression. SLNB should also be strongly considered in younger patients (e.g. < 40 years old), especially in the presence of additional adverse features. All patients who do not proceed with sentinel lymph node biopsy must be carefully followed to monitor for regional relapse.
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: mekupfer@mdanderson.org.
Michael E
ME
Kupferman
Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Mark W
MW
Kubik
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
Carol R
CR
Bradford
Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
Francisco J
FJ
Civantos
Department of Pathology, Allegiance Health, Jackson, MI, USA.
Kenneth O
KO
Devaney
Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Jesus E
JE
Medina
ENT Clinic, University of Udine, Udine, Italy.
Alessandra
A
Rinaldo
Department of Otorhinolaryngology-Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Sandro J
SJ
Stoeckli
Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
Robert P
RP
Takes
ENT Clinic, University of Udine, Udine, Italy.
Alfio
A
Ferlito
D003937:Diagnosis, Differential; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000556:secondary; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000175:diagnosis* / Q000556:secondary; D009333:Neck; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms; D000096142:Cutaneous Malignant Melanoma