Review and evaluation of sentinel node procedures in 250 melanoma patients with a median follow-up of 6 years

被引:119
作者
Estourgie, SH
Nieweg, OE
Olmos, RAV
Hoefnagel, CA
Kroon, BBR
机构
[1] Antoni Van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Surg, NL-1066 CX Amsterdam, Netherlands
[2] Antoni Van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Nucl Med, NL-1066 CX Amsterdam, Netherlands
关键词
analysis; melanoma; morbidity; recurrence; sentinel node; survival;
D O I
10.1245/ASO.2003.01.023
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The aim of this study was to evaluate the results of sentinel node biopsy in cutaneous melanoma at our institute. Methods: A total of 250 patients with cutaneous melanoma were studied prospectively. Preoperative lymphoscintigraphy was performed after injection of Tc-99m-nanocolloid intradermally around the primary tumor or biopsy site (.32 mL, 65.5 MBq [1.8 mCi]). The sentinel node was surgically identified with the aid of patent blue dye and a gamma ray detection probe. The median follow-up was 72 months. Results: Lymphoscintigraphic visualization was 100%, and surgical identification was 99.6%. In 60 patients (24%), 1 or more sentinel nodes were tumor positive at initial pathology evaluation. Late complications after sentinel node biopsy of the remaining 190 patients were seen in 35 patients (18%). The false-negative rate was 9%. In-transit metastases were seen in 7% of sentinel nodenegative and 23% of sentinel node-positive patients. The estimated 5-year overall survival rates were 89% and 64%, respectively (P < .001). Conclusions: This study confirms that the status of the sentinel node is a strong independent prognostic factor. The false-negative rate and the incidence of in-transit metastases in sentinel node-positive patients are high and have to be weighed against the possible survival benefit of early removal of nodal metastases.
引用
收藏
页码:681 / 688
页数:8
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