title: Sentinel lymph node biopsy staging for cutaneous malignant melanoma of the head and neck.
abstract: Conclusion Sentinel lymph node biopsies (SLNBs) can be performed safely and with reasonable accuracy in HNM patients. The outcome provides important prognostic information concerning DFS and further treatment. However, one must recognize that SLNB is a multidisciplinary procedure with a learning curve for all. Objectives To evaluate efficacy of performing SLNBs in a series of consecutive patients with cutaneous head and neck melanoma (HNM) ≥ T1b from introduction of the procedure and 10 years onward. Method End-points comprised of SLNB outcome, disease-free survival (DFS), and overall survival (OS). Results SNs were harvested in 128 of 160 patients (median Breslow = 2.0 mm, 29% ulcerated); success rate = 80.0%, or 92.1% if excluding patients where SLNBs were omitted due to non-localization on pre-operative imaging or because of SN-location in the parotid basin. Ten patients (7.8%) had positive SLNBs and were offered early completion neck dissections. Of the 146 patients available for follow-up (median = 27 months), 15.8% had recurrent disease. The risk of a regional nodal recurrence after a negative SLNB was 7.5%. SN-negative patients had improved DFS c.f. SN-positive patients (p < 0.001). A positive SLNB was the most important prognostic predictor of decreased DFS (hazard ratio = 5.70; p < 0.005), but had no significant impact on OS.
authors.affiliation: a Department of ORL, Head & Neck Surgery , Skåne University Hospital , Lund , Sweden ;
authors.forename: Anna
authors.initials: A
authors.lastname: Hafström
authors.affiliation: a Department of ORL, Head & Neck Surgery , Skåne University Hospital , Lund , Sweden ;
authors.forename: Anton
authors.initials: A
authors.lastname: Romell
authors.affiliation: b Department of Surgery , Skåne University Hospital , Lund , Sweden.
authors.forename: Christian
authors.initials: C
authors.lastname: Ingvar
authors.affiliation: a Department of ORL, Head & Neck Surgery , Skåne University Hospital , Lund , Sweden ;
authors.forename: Peter
authors.initials: P
authors.lastname: Wahlberg
authors.affiliation: a Department of ORL, Head & Neck Surgery , Skåne University Hospital , Lund , Sweden ;
authors.forename: Lennart
authors.initials: L
authors.lastname: Greiff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D061305:Lymphoscintigraphy; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D013548:Sweden / Q000453:epidemiology; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Malignant melanoma; disease free survival; head and neck; overall survival; sentinel lymph node biopsy; sentinel node