Is sentinel node biopsy beneficial in melanoma patients? A report on 200 patients with cutaneous melanoma

被引:61
作者
Doting, MHE
Hoekstra, HJ
Plukker, JTM
Piers, DA
Jager, PL
Tiebosch, ATMG
Vermey, A
Koops, HS
机构
[1] Univ Groningen Hosp, Dept Surg Oncol, NL-9700 RB Groningen, Netherlands
[2] Univ Groningen Hosp, Dept Nucl Med, NL-9700 RB Groningen, Netherlands
[3] Univ Groningen Hosp, Dept Pathol & Lab Med, NL-9700 RB Groningen, Netherlands
来源
EUROPEAN JOURNAL OF SURGICAL ONCOLOGY | 2002年 / 28卷 / 06期
关键词
sentinel node biopsy; melanoma;
D O I
10.1053/ejso.2002.1297
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aim: The aim of this study was to evaluate the reliability and clinical impact of sentinel node biopsy, including preoperative lymphoscintigraphy and intraoperative lymphatic mapping in patients with cutaneous melanoma of the head, neck, trunk or extremities. Methods: Two hundred patients (103 women, 97 men), median age 57 (range 21-86) years with cutaneous melanoma greater than or equal to1.0mm Breslow thickness and clinically negative lymph nodes participated in a single institutional prospective study from May 1995 to January 2000. Primary melanoma sites included: 22 head and neck (11%), 67 trunk (34%), 29 upper extremity (14%) and 82 lower extremity (41%). The median Breslow thickness was 2.5 (range 1.0-20.0) mm. Preoperative dynamic and static lymphoscintigraphy, intraoperative blue dye and a gamma detection probe were used. If histological examination with HE or IHC showed metastases, therapeutic lymph node dissection (TLND) was performed. Results: Sentinel node(s) could be identified in 197 patients (99%); 393 sentinel nodes (mean: 2.0 per patient, range 1-7) were removed from 241 basins. Three procedures failed in the head and neck region. In 167 patients, the sentinel nodes were both blue and radioactive (85%); in 26 patients, they were only radioactive (13%) and in four patients only blue (2%). In total, 150 patients had tumour-negative sentinel nodes (76%). During a median follow-up of 47 (range 24-79) months, nodal recurrence in a negative mapped basin was documented in six patients of which isolated recurrence was in two patients and recurrence together with locoregional recurrence in four patients (false negative rate 6/54 = 11%). Estimated three-year recurrence-free survival in the node-negative patients and nodepositive patients was 83 and 66% respectively (P < 0.05). The overall survival at three years was 92 and 73% respectively (P < 0.05). Conclusion: Sentinel node biopsy provides accurate staging and important prognostic information. The final place of sentinel node biopsy is still undefined, and therefore sentinel node biopsy is still considered as an experimental surgical staging procedure. (C) 2002 Published by Elsevier Science Ltd.
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收藏
页码:673 / 678
页数:6
相关论文
共 43 条
  • [1] Intraoperative radiolymphoscintigraphy improves sentinel lymph node identification for patients with melanoma
    Albertini, JJ
    Cruse, CW
    Rapaport, D
    Wells, K
    Ross, M
    DeConti, R
    Berman, CG
    Jared, K
    Messina, J
    Lyman, G
    Glass, F
    Fenske, N
    Reintgen, DS
    [J]. ANNALS OF SURGERY, 1996, 223 (02) : 217 - 224
  • [2] Balch CM, 1999, J AM COLL SURGEONS, V189, P204
  • [3] Balch CM, 1999, ANN SURG, V230, P463
  • [4] Long-term results of a multi-institutional randomized trial comparing prognostic factors and surgical results for intermediate thickness melanomas (1.0 to 4.0 mm)
    Balch, CM
    Soong, SJ
    Ross, MI
    Urist, MM
    Karakousis, CP
    Temple, WJ
    Mihm, MC
    Barnhill, RL
    Jewell, WR
    Wanebo, HJ
    Harrison, R
    [J]. ANNALS OF SURGICAL ONCOLOGY, 2000, 7 (02) : 87 - 97
  • [5] Efficacy of an elective regional lymph node dissection of 1 to 4 mm thick melanomas for patients 60 years of age and younger
    Balch, CM
    Soong, SJ
    Bartolucci, AA
    Urist, MM
    Karakousis, CP
    Smith, TJ
    Temple, WJ
    Ross, MI
    Jewell, WR
    Mihm, MC
    Barnhill, RL
    Wanebo, HJ
    [J]. ANNALS OF SURGERY, 1996, 224 (03) : 255 - 263
  • [6] Sentinel lymph node biopsy in cutaneous melanoma: The WHO Melanoma Program experience
    Cascinelli, N
    Belli, F
    Santinami, M
    Fait, V
    Testori, A
    Ruka, W
    Cavaliere, R
    Mozzillo, N
    Rossi, CR
    MacKie, RM
    Nieweg, O
    Pace, M
    Kirov, K
    [J]. ANNALS OF SURGICAL ONCOLOGY, 2000, 7 (06) : 469 - 474
  • [7] Immediate or delayed dissection of regional nodes in patients with melanoma of the trunk: a randomised trial
    Cascinelli, N
    Morabito, A
    Santinami, M
    MacKie, RM
    Belli, F
    [J]. LANCET, 1998, 351 (9105) : 793 - 796
  • [8] Daryanani D, 2000, Lancet Oncol, V1, P211, DOI 10.1016/S1470-2045(00)00165-0
  • [9] Improved staging of node-negative patients with intermediate to thick melanomas (&gt;1 mm) with the use of lymphatic mapping and sentinel lymph node biopsy
    Dessureault, S
    Soong, SJ
    Ross, MI
    Thompson, JF
    Kirkwood, JM
    Coit, DG
    McMasters, KM
    Balch, CM
    Reintgen, D
    [J]. ANNALS OF SURGICAL ONCOLOGY, 2001, 8 (10) : 766 - 770
  • [10] Efficacy of lymphatic mapping, sentinel lymphadenectomy, and selective complete lymph node dissection as a therapeutic procedure for early-stage melanoma
    Essner, R
    Conforti, A
    Kelley, MC
    Wanek, L
    Stern, S
    Glass, E
    Morton, DL
    [J]. ANNALS OF SURGICAL ONCOLOGY, 1999, 6 (05) : 442 - 449