Sentinel lymph node biopsy in head and neck melanoma

Giudice, Giuseppe

doi:10.11138/gchir/2014.35.5.149

Cited by 13 publications

(13 citation statements)

References 25 publications

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“…Detection and identification of the SLN itself is complicated by the generally short distances between primary lesion and nodal basin, and due to the complexities of the lymphatic drainage patterns in this region, clinically predicted pathways are often discordant from those identified using preoperative lymphoscintigraphy . A trained multidisciplinary team of physicians who treat melanoma of the head and neck is required for accurate technical performance of the procedure in this group of patients with cutaneous melanoma …”

Section: Discussionmentioning

confidence: 99%

“…14,15 A trained multidisciplinary team of physicians who treat melanoma of the head and neck is required for accurate technical performance of the procedure in this group of patients with cutaneous melanoma. 26 Given the higher rate of false negatives with SLN biopsy in patients with head and neck melanoma, a negative biopsy derives less confidence in a favorable patient outcome. Based on MSLT-II, fewer completion lymph node dissections may be performed in the future and their added prognostic information will thus be mitigated.…”

Section: Discussionmentioning

confidence: 99%

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Performance of a 31‐gene expression profile test in cutaneous melanomas of the head and neck

et al. 2019

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Background We report the performance of a gene expression profile test to classify the recurrence risk of cutaneous melanoma tumors of the head and neck as low‐risk Class 1 or high‐risk Class 2. Methods Of note, 157 primary head and neck cutaneous melanoma tumors were identified. Survival analyses were performed using Kaplan‐Meier and Cox methods. Results Gene expression profile class and node status stratified tumors into significantly different 5‐year survival groups by Kaplan‐Meier method ( P < .0001 for all end points), and both were independent predictors of recurrence in multivariate analysis. Overall, 74% of distant metastases and 88% of melanoma‐specific deaths had Class 2 risk. Conclusion The gene expression profile test identifies cases at increased risk for metastasis and death independent of a clinically or pathologically negative nodal status, suggesting that incorporation of this molecular tool could improve clinical management of patients with head and neck cutaneous melanoma, especially in those with a negative sentinel lymph node biopsy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Performance of a 31‐gene expression profile test in cutaneous melanomas of the head and neck

et al. 2019

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“…From July 1994 to December 2012 in the clinical practice of the Department of Plastic Surgery of the University of Bari, we analyzed 680 patients suffering from melanoma, focusing our study on head-neck melanoma patients (HNM). 8 The disease-free period is significantly shorter in HNM patients compared with those affected with melanoma in other areas like the limbs and the torso, probably due to early lymphatic involvement. SLN in HNM presents intrinsic difficulties: lymphatic drainage in this region is complex, with multiple primary channels and multiple lymph node basins.…”

Section: Sirmentioning

confidence: 95%

Current management of regional lymph nodes in patients with melanoma

Ciancio

Nacchiero

Perrotta

2019

Journal of Surgical Oncology

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“…This is even more true in melanomas arising in specific surgical sites (such as the head and neck), because the presence of the high complexity and variability of lymphatic drainage. [6] Sentinel lymphs (SLs) arising outside of conventional basins were called in different ways ( aberrant , in-transit , ectopic , or intercalated) during years, [7–10] but nowadays literature termed them as interval sentinel lymph nodes (INs). [11–13] INs lie in subcutaneous fat along the course of lymphatic collecting vessels between a primary tumor site and a draining node field.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of tumor-positive interval node in melanoma patients

Nacchiero¹,

Vestita²,

Robusto³

et al. 2018

Medicine

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The presence of interval nodes (IN) in melanoma is testified in several studies and sometimes these lymph nodes can contain metastatic disease. Currently there are no guidelines about the management of patients with tumor-positive INs.We enrolled all patients affected by melanoma who underwent sentinel lymph node biopsy (SLNB) in a single institution. All patients with tumor-positive IN underwent the lymphadenectomy of the subsequent draining lymphatic field. Prognosis of IN+-patients was compared with subjects with positive SLNB in usual field through Kaplan-Meier and multivariate Cox regression analysis.Overall 596 subjects underwent lymphoscintigraphy and one or more INs were identified in 94 (15.8%) patients. The mean number of sentinel lymph nodes (SNs) identified per patient was significantly higher in patients with INs. Macrometastasis were more common in patients with INs. Matched pair analysis testified a statistically significant better prognosis in patients with positive-INs when compared with patients with positive SNs in usual side with the same demographic and clinical characteristics. These findings were confirmed both in analysis of 10-year recurrence-free period, then in 10-years overall survival analysis.Lymphadenectomy of the lymphatic draining field beyond positive-IN testify has proved to be a safe procedure that may improve prognosis in melanoma patients with tumor-positive INs. The better prognosis of patients with tumor-positive INs undergoing lymphadenectomy may be justified by the earlier treatment of lymphatic metastases. Further multicentric comparative studies are needed to evaluate possible impact of this procedure on prognosis of melanoma patients.

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Sentinel lymph node biopsy in head and neck melanoma

Cited by 13 publications

References 25 publications

Performance of a 31‐gene expression profile test in cutaneous melanomas of the head and neck

Performance of a 31‐gene expression profile test in cutaneous melanomas of the head and neck

Current management of regional lymph nodes in patients with melanoma

Surgical management of tumor-positive interval node in melanoma patients

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