[Sentinel lymph node biopsy in melanoma patients: methods, indications, and clinical significance] (original) (raw)
Related papers
Sentinel lymph node biopsy for melanoma: indications and rationale
Cancer control : journal of the Moffitt Cancer Center, 2009
The disease status of regional lymph nodes is the most important prognostic indicator for patients with melanoma. Sentinel lymph node biopsy (SLNB) was developed as a technique to surgically assess the regional lymph nodes and spare node-negative patients unnecessary and potentially morbid complete lymphadenectomies. We reviewed the literature on SLNB for cutaneous melanoma to provide insight into the rationale for the current widespread use of SLNB. Multiple studies show that the status of the SLN is an important prognostic indicator. Those with positive SLNs have significantly decreased disease-free and melanoma-specific survival compared with those who have negative SLNs. In the Multicenter Selective Lymphadenectomy Trial I (MSLT-I), in which patients with intermediate-thickness melanoma were randomized to SLNB (and immediate completion lymphadenectomy if the SLN was positive) vs observation (and a lymphadenectomy only after presenting with clinically evident recurrence), the 5-y...
Sentinel lymph node biopsy in melanoma: Facts and controversies
Clinics in Dermatology, 2010
Three decades after its introduction in the 1990s, the sentinel lymph node biopsy for patients with localized cutaneous melanoma is still the subject of great debate in dermatology. Many questions remain unanswered, and studies currently in progress may or may not bring us any closer to determining the truth about sentinel lymph node biopsy and melanoma. We discuss the effect of sentinel lymph node biopsy on overall survival, the clinical and therapeutic implications of sentinel lymph node biopsy, and the melanoma patients who might be candidates for sentinel lymph node biopsy.
Sentinel Lymph Node Biopsy in Cutaneous Melanoma, a Clinical Point of View
Medicina
Sentinel lymph node biopsy (SLNB) is a surgical procedure that has been used in patients with cutaneous melanoma for nearly 30 years. It is used for both staging and regional disease control with minimum morbidity, as proven by numerous worldwide prospective studies. It has been incorporated in the recommendations of national and professional guidelines. In this article, we provide a summary of the general information on SLNB in the clinical guidelines for the management of cutaneous malignant melanoma (American Association of Dermatology, European Society of Medical Oncology, National Comprehensive Cancer Network, and Cancer Council Australia) and review the most relevant literature to provide an update on the existing recommendations for SLNB.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2014
Actual trends of cutaneous malignant melanoma show a faster increase then other forms of cancer. Early detection and diagnosis, and accurate pathologic interpretation of the biopsy specimen is extremely important for the treatment and prognosis of clinically localized melanoma. The surgical approach to cutaneous melanoma patients with clinically uninvolved regional lymph nodes remains controversial. A retrospective study of melanoma cases was conducted in the "Casa Austria" Department of Plastic and Reconstructive Surgery, Emergency County Hospital, Timisoara, Romania. We have analyzed the medical records of 21 patients that underwent surgical treatment for different stages of melanoma in the period 2008-2012. For histopathological diagnosis of melanoma and the sentinel lymph node(s) status, tissular fragments were routinely processed. For the difficult cases, additional immunohistochemical investigation was done. A positive family history was noted in two cases. The prese...
Journal of Biomedical and Clinical Research, 2013
SummaryIn the last 15 years, sentinel lymph node biopsy (SLNB) for patients with malignant melanoma (MM) has been introduced into the clinical practice. Our aim was to make a retrospective analysis of clinical results in order to assess the success ratio of SLNB and the variables affecting it in MM patients, treated in the Oncology Center at the University Hospital “Dr George Stranski” - Pleven, Bulgaria for a 4-year period. A research index card was used to process the oncologic files of 82 out of 102 patients with MM, treated and monitored at the Oncology centre between 01.01.2008 and 31.12.2011. TNM-stages, Breslow and Clark levels, location, characteristics of the skin lesion, diagnostic excision, type of lymph node dissection, number of SLN, localization of SLN, etc. were registered in the index card. SLNB staging was carried out in 28 patients. Sentinel lymph nodes were found in 22 of them. The success ratio of the method was 78.6%. Histologically, metastatic SLN were found in...
BMC Dermatology, 2012
Background: Since the introduction of sentinel lymph node biopsy (SLNB), its use as a standard of care for patients with clinically node-negative cutaneous melanoma remains controversial. We wished to evaluate our experience of SLNB for melanoma. Methods: A single center observational cohort of 203 melanoma patients with a primary cutaneous melanoma (tumour thickness > 1 mm) and without clinical evidence of metastasis was investigated from 2002 to 2009. Head and neck melanoma were excluded. SLN was identified following preoperative lymphoscintigraphy and intraoperative gamma probe interrogation.
2014
Background: Melanoma incidence has been increasing worldwide. For localized melanoma, the status of the sentinel lymph node is the most important prognostic factor. This study aimed to evaluate the systematization of a technique to identify the sentinel lymph node anatomically by using lymphoscintigraphy and patent blue. Method: A total of 12 cases were studied between March 2009 and March 2012. The treatment protocol followed criteria established by the Brazilian Group of Melanoma. Patients were evaluated for age, sex, thickness of the primary lesion, localization of drainage site of the sentinel lymph node, and presence of metastases. Results: The majority of patients were male and the mean age was 49.7 years. The types of thickness most frequently found were Breslow thickness 0–1 mm and Clark level II. All of the dissected lymph nodes were stained with patent blue. Histological and immunohistochemical analysis of the lymph nodes were negative for metastases. Conclusions: The comb...
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2006
UNLABELLED An observational multicentric Italian trial on sentinel node biopsy (SNB) in melanoma patients was performed to diffuse a common SNB protocol nationwide (Italy). We report herein the results of this trial. The influence of some technical aspects on the outcome of SNB was also investigated, because a certain degree of variability was accepted in performing lymphoscintigraphy. METHODS From January 2000 to December 2002, 1,313 consecutive patients with primary cutaneous melanoma (Breslow thickness, >1.0 mm or <1.0 mm but with ulceration, Clark level IV-V, presence of regression) were enrolled by 23 centers. One half to 1 mL of 99mTc-labeled human albumin colloid, at a suggested dosage of 5-15 or 30-70 MBq, was injected intradermally, closely around the scar, the same day or the day before SNB. Intraoperatively, Patent blue was associated when a definitive wide excision of the primary was required. A positive sentinel node (SN) was defined when containing melanoma cells...
Sentinel-lymph-node biopsy (SLNB) for melanoma is not complication-free
Ejso, 2004
Background and aim. Sentinel lymph node biopsy (SLNB) is reportedly associated with insignificant morbidity. The study aims at documenting SLNB-related complications and identifying possible risk factors. Method. Data of all melanoma patients who underwent SLNB in our medical center (1994-2002) were analysed. Procedure-related complications were recorded. Results. Three hundred and nine lymphatic basins of 250 patients were explored for SLNB. Overall complication rate was 20%. Sensory morbidity was significantly associated with axillary SLNB (pZ0.04) and was more prevalent in younger patients. The use of blue dye alone or combined with a hand-held gamma probe had no statistically significant impact on the identification rate. There were six falsenegatives (2.3%), for an overall false-negative rate of 18%. A positive sentinel node was significantly associated with shortened overall survival (pZ0.04). Conclusion. Wound complications are more frequent than usually reported. Sensory morbidity occurs mostly in the axilla. Neck SLNB is associated with the highest rate of identification failure. Patient age, basin location, and number of excised nodes may serve as prognostic factors of morbidity.