Is pelvic sentinel node biopsy necessary for lower extremity and trunk melanomas? - 27/09/17

Doi : 10.1016/j.amjsurg.2017.03.028

Darryl Schuitevoerder, MBBS ^a,^⁎ , Stanley P.L. Leong, MD ^b, Jonathan S. Zager, MD ^c, Richard L. White, MD ^d, Eli Avisar, MD ^e, Heidi Kosiorek, MS ^f, Amylou Dueck, PhD ^f, Jeanine Fortino, HIMA ^g, Mohammed Kashani-Sabet, MD ^b, Kyle Hart, MS ^a, John T. Vetto, MD ^g
^a Department of Surgery, Oregon Health & Science University, Portland, OR, USA
^b Center for Melanoma Research and Treatment, Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA
^c Departments of Cutaneous Oncology and Sarcoma, Moffitt Cancer Center, Tampa, FL, USA
^d Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC, USA
^e Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
^f Section of Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA
^g Department of Surgery, Division of Surgical Oncology, Oregon Health & Science University, Portland, OR, USA

^∗Corresponding author. Oregon Health & Science University, Department of Surgery, 3181 S.W. Sam Jackson Park Rd., Mail code L223, Portland, OR 97239, USA.Oregon Health & Science UniversityDepartment of Surgery3181 S.W. Sam Jackson Park Rd.Mail code L223PortlandOR97239USA

Abstract

Objective

There is currently no consensus regarding how to address pelvic sentinel lymph nodes (PSLNs) in melanoma. Thus, our objectives were to identify the incidence and clinical impact of PSLNs.

Methods

Retrospective review of a prospectively collected multi-institutional melanoma database.

Results

Of 2476 cases of lower extremity and trunk melanomas, 227 (9%) drained to PSLNs (181 to both PSLNs and superficial (inguinal or femoral) sentinel lymph nodes (SSLN) and 46 to PSLNs alone). Seventeen (7.5%) of 227 PSLN cases were positive for nodal metastasis, 8 of which drained to PSLNs only while 9 drained to both PSLNs and SSLNs. Complication rates between PSLN and SSLN biopsy were similar (15% vs. 14% respectively). In 181 cases with drainage to both SSLNs and PSLNs, PSLN biopsy upstaged one patient (0.6%), and completion dissection based on a positive PSLN did not upstage any.

Conclusions

PSLN biopsy is safe, however in the setting of negative SSLNs there is minimal clinical impact. We therefore recommend PSLN biopsy when the SSLNs are positive or when the tumor drains to PSLNs alone.

Le texte complet de cet article est disponible en PDF.

Keywords : Pelvic node, Iliac/obturator node, Sentinel lymph node biopsy, Melanoma

Plan

Export

Vol 213 - N° 5

P. 921-925 - mai 2017 Retour au numéro

Article précédent

Specific gene expression profiles are associated with a pathologic complete response to neoadjuvant therapy in esophageal adenocarcinoma
Patrick J. McLaren, Anthony P. Barnes, Willy Z. Terrell, Gina M. Vaccaro, Jack Wiedrick, John G. Hunter, James P. Dolan

| Article suivant

More is better: Lymph node harvesting in colorectal cancer
Sean O'Boyle, Keith Stephenson

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

connectez-vous ou créez un compte

Is pelvic sentinel node biopsy necessary for lower extremity and trunk melanomas? - 27/09/17

Abstract

Objective

Methods

Results

Conclusions

Plan

Export citations

Fichier

Contenu

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL