Sentinel Lymph Node Biopsy Provides Prognostic Value in Thick Head and Neck Melanoma

Monroe, Marcus M.; Pattisapu, Prasanth; Myers, Jeffrey N.; Kupferman, Michael E.

doi:10.1177/0194599815589948

Cited by 18 publications

(20 citation statements)

References 34 publications

(92 reference statements)

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“…The accuracy and prognostic implications of SLNB of the head and neck has been validated through multiple studies . This study evaluated the largest patient cohort to have had SLNB after WLE with primary melanoma of the head and neck.…”

Section: Discussionmentioning

confidence: 99%

Wide local excision prior to sentinel lymph node biopsy for primary melanoma of the head and neck

et al. 2019

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Background Previous wide local excision prior to sentinel lymph node biopsy (SLNB) may have the potential to disrupt lymphatic channels, thus incorrectly identifying the sentinel node. The purpose of this study was to investigate: (1) regional recurrence rates of prior wide local excision compared to other biopsy techniques and (2) survival outcomes in patients with melanoma of the head and neck. Methods Between the years 2000 and 2016, 391 cases were reviewed with a median follow‐up time of 30 months in a large tertiary care center. Biopsy practices included shave, punch, wide local excision, and narrow margin excisional/Mohs, and associations with time to local or regional relapse and death from melanoma were evaluated. Main outcomes included identification of sentinel lymph nodes, overall survival, and melanoma‐specific survival. Results Of the 391 patients, biopsy patterns were as follows: 77 (19%) unknown biopsy, 30 (8%) prior wide local excision (WLE), 105 (27%) narrow margin excisional biopsy, 69 (18%) punch biopsy, and 110 (28%) shave biopsy. SLNB was successfully identified in all 30 patients whom had a prior WLE. There were 50 regional recurrences in the neck and 27 local recurrences with the median (IQR) at 1.2 years and 1.0 years, respectively. Multivariable associations of type of prior biopsy, depth of invasion, and nodal status with time to regional recurrence, local recurrence, overall survival, and melanoma‐specific survival were not significantly different. Conclusions Sentinel lymph node biopsy for melanoma of the head and neck can be successfully performed in patients after previous wide local excision.

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Section: Discussionmentioning

confidence: 99%

Wide local excision prior to sentinel lymph node biopsy for primary melanoma of the head and neck

et al. 2019

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“…In 2018, 91 270 new cases were diagnosed with 9320 deaths . The most important prognostic factor in early‐stage melanoma is the detection of sentinel lymph node (SLN) metastasis . This information is used in determining the patient's future surveillance, eligibility for adjuvant therapy, and enrollment in clinical trials …”

Section: Introductionmentioning

confidence: 99%

Frequency and implications of occipital and posterior auricular sentinel lymph nodes in scalp melanoma

Carmichael¹,

King²,

Friedman³

et al. 2019

Journal of Surgical Oncology

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Background Patients with scalp melanoma have poor oncologic outcomes compared with those with other cutaneous sites. Sentinel lymph node (SLN) biopsy provides prognostic information but is challenging in the head and neck. We explore the anatomic distribution of scalp melanoma and describe the most common sites of SLN drainage and of SLN metastatic disease. Methods Retrospective review of scalp melanoma patients who underwent SLN biopsy. Melanoma location was classified as frontal, coronal apex, coronal temporal, or posterior scalp. SLN location was classified by lymph node level and region. Results We identified 128 patients with scalp melanoma. The most common primary tumor location was the posterior scalp (43%) and the most frequent SLN drainage site was the level 2 lymph node basin (48%). Total 31 patients (24%) had metastatic disease in an SLN. Scalp SLNs, classified as being in the posterior auricular or occipital region, were localized in 26% of patients. For patients in which a scalp SLN was identified, 30% had a positive scalp SLN (n = 10). Conclusions Scalp SLNs are frequent drainage sites for scalp melanoma and, when found, have a 30% chance of harboring metastatic disease. Surgeons, radiologists, and pathologists should be vigilant in identifying, removing, and analyzing scalp SLNs.

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“…5 Diseasepositive SLN are correlated with higher locoregional recurrence rates and a poor survival prognosis even in the presence of a therapeutic neck dissection and adjuvant therapy. 6 Several techniques for SLN mapping are currently in clinical use. Their features have been evolving to achieve higher quality of anatomical visualization, less invasiveness and easy reproducibility.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer—a pilot study

Gvetadze

Xiong

et al. 2017

Dentomaxillofacial Radiology

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Objectives: To assess the usefulness of contrast-enhanced ultrasound (CEUS) with peritumoral injection of microbubble contrast agent for detecting the sentinel lymph nodes for oral tongue carcinoma. Methods: The study was carried out on 12 patients with T1-2cN0 oral tongue cancer. A radical resection of the primary disease was planned; a modified radical supraomohyoid neck dissection was reserved for patients with larger lesions (T2, n 5 8). The treatment plan and execution were not influenced by sentinel node mapping outcome. The SonovueÔ contrast agent (Bracco Imaging, Milan, Italy) was utilized. After detection, the position and radiologic features of the sentinel nodes were recorded. Results: The identification rate of the sentinel nodes was 91.7%; one patient failed to demonstrate any enhanced areas. A total of 15 sentinel nodes were found in the rest of the 11 cases, with a mean of 1.4 nodes for each patient. The sentinel nodes were localized in: Level IA-1 (6.7%) node; Level IB-11 (73.3%) nodes; Level IIA-3 (20.0%) nodes. No contrastrelated adverse effects were observed. Conclusions: For oral tongue tumours, CEUS is a feasible and potentially widely available approach of sentinel node mapping. Further clinical research is required to establish the position of CEUS detection of the sentinel nodes in oral cavity cancers. Dentomaxillofacial Radiology (2017Radiology ( ) 46, 20160345. doi: 10.1259 Cite this article as: Gvetadze SR, Xiong P, Lv M, Li J, Hu J, Ilkaev KD, et al. Contrastenhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer-a pilot study.

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Sentinel Lymph Node Biopsy Provides Prognostic Value in Thick Head and Neck Melanoma

Abstract: SLNB provides accurate staging of the regional node basin and important prognostic information for patients with thick HNM.

Cited by 18 publications

References 34 publications

Wide local excision prior to sentinel lymph node biopsy for primary melanoma of the head and neck

Wide local excision prior to sentinel lymph node biopsy for primary melanoma of the head and neck

Frequency and implications of occipital and posterior auricular sentinel lymph nodes in scalp melanoma

Contrast-enhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer—a pilot study

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