Sentinel node guided surgery for melanoma in the head and neck region

Shpitzer, Thomas; Segal, Karl; Schachter, Jacob; Hardoff, Ruth; Guttman, Dan; Ulanovski, David; Feinmesser, Raphael; Gutman, Haim

doi:10.1097/01.cmr.0000132229.62574.0b

Cited by 21 publications

(23 citation statements)

References 22 publications

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“…Therefore, we chose general anesthesia whenever possible (20/21 patients; 95%). In our experience, the percentage (12% SN, 14.3% patients) of positive SNs in the HN was similar to that reported by other authors [28], although our series was too small to permit statistical analysis.…”

Section: Discussionsupporting

confidence: 88%

The single-photon emission computed tomography/computed tomography: a new procedure to perform the sentinel node biopsy in patients with head and neck melanoma

Covarelli¹,

Tomassini

Simonetti

et al. 2007

Melanoma Research

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The aim of this study was to define and validate a new technique to detect the sentinel node (SN) in patients treated for head and neck melanoma. In a small series of 23 head and neck melanoma patients, lymphatic mapping was followed by SN biopsy, using in 12 patients a new diagnostic imaging technique, single-photon emission computed tomography/computed tomography. The procedure is described and the major problems encountered are discussed. The preliminary data show that identification of SN using single-photon emission computed tomography/computed tomography never failed in 12 patients, and biopsies performed, compared with those in a standard group, took significantly less time (Mann-Whitney test P=0.006). In conclusion, the authors underline the possibility of a wide use for this technique.

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Section: Discussionsupporting

confidence: 88%

The single-photon emission computed tomography/computed tomography: a new procedure to perform the sentinel node biopsy in patients with head and neck melanoma

Covarelli¹,

Tomassini

Simonetti

et al. 2007

Melanoma Research

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“…Previous data suggest a higher false‐omission rate in the head and neck region relative to nonhead and neck regions. After recalculations were made where necessary, the compiled false‐omission rate across head and neck melanoma series with a minimum 30‐month follow‐up is 9.3% 8, 10, 20‐25. The literature predicts a lower false‐omission rate when considering nonhead and neck melanomas, including the European Organization for Research and Treatment of Cancer Melanoma Group data set (4.7%),17 John Wayne Cancer Center data set (4.8%),26 Multicenter Selective Lymphadenectomy Trial 1 (3.4%),18 and others 7, 19.…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy is accurate and prognostic in head and neck melanoma

Erman

Collar

Griffith

et al. 2011

Cancer

137

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BACKGROUND: Sentinel lymph node biopsy (SLNB) has emerged as a widely used staging procedure for cutaneous melanoma. However, debate remains around the accuracy and prognostic implications of SLNB for cutaneous melanoma arising in the head and neck, as previous reports have demonstrated inferior results to those in nonhead and neck regions. Through the largest single-institution series of head and neck melanoma patients, the authors set out to demonstrate that SLNB accuracy and prognostic value in the head and neck region are comparable to other sites. METHODS: A prospectively collected database was queried for cutaneous head and neck melanoma patients who underwent SLNB at the University of Michigan between 1997 and 2007. Primary endpoints included SLNB result, time to recurrence, site of recurrence, and date and cause of death. Multivariate models were constructed for analyses. RESULTS: Three hundred fifty-three patients were identified. A sentinel lymph node was identified in 352 of 353 patients (99.7%). Sixty-nine of the 353 (19.6%) patients had a positive SLNB. Seventeen of 68 patients (25%) undergoing completion lymphadenectomy after a positive SLNB result had at least 1 additional positive nonsentinel lymph node. Patients with local control and a negative SLNB failed regionally in 4.2% of cases. Multivariate analysis revealed positive SLNB status to be the most prognostic clinicopathologic predictor of poor outcome; hazard ratio was 4.23 for SLNB status and recurrence-free survival (P < .0001) and 3.33 for overall survival (P < .0001). CONCLUSIONS: SLNB is accurate and its results are of prognostic importance for head and neck melanoma patients. Cancer 2012;118:1040-

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“…In these cases, preoperative lymphoscintigraphy is a critical component of the procedure. Studies have shown that the combination of blue dye injection with intraoperative hand-held gamma-probe evaluation identifies the sentinel lymph node in > 90% of patients with head and neck melanoma [5,14,15]. The use of both techniques is crucial, because the blue dye staining is not as vivid in the neck as in the axilla or groin [16].…”

Section: Discussionmentioning

confidence: 98%

Sentinel node-guided evaluation of drainage patterns for melanoma of the helix of the ear

Shpitzer¹,

Gutman²,

Barnea

et al. 2007

Melanoma Research

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The head and neck region, and especially the ear and its helix, is notorious for its ambiguous pattern of lymphatic drainage. Therefore, the primary nodal drainage basins in melanoma of the helix of the ear are often unpredictable. The aim of the study was to examine the value of sentinel lymph node biopsy in melanoma of the helix of the ear and to describe the natural history of the disease. Fifteen consecutive patients (14 men) with primary melanoma of the helix of the ear (median thickness, 1.2 mm; range, 0.7-10.0) underwent preoperative lymphoscintigraphy, followed by intraoperative lymphatic mapping, using blue dye in combination with a hand-held gamma probe and sentinel lymphadenectomy. The melanomas were characterized by low mitotic rate, low lymphocytic infiltrate, low spontaneous-regression rate, and mostly epitheloid cell type. In one patient, preoperative lymphoscintigraphy failed to demonstrate the draining nodes. The sentinel lymph nodes were identified and retrieved in all patients during surgery. In 13 patients (87%), they were found in the upper jugular lymphatic basin (level IIA); none were found in the retroauricular region. All sentinel lymph nodes were tumor-negative. At a median follow-up of 39 months (range, 12-73), all 15 patients were disease-free. In conclusion, sentinel lymph node biopsy for helix melanoma is an excellent alternative to elective lymph node neck dissection and superficial parotidectomy, with a high success rate and low morbidity. Melanoma of the helix of the ear has an indolent natural history.

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Sentinel node guided surgery for melanoma in the head and neck region

Cited by 21 publications

References 22 publications

The single-photon emission computed tomography/computed tomography: a new procedure to perform the sentinel node biopsy in patients with head and neck melanoma

The single-photon emission computed tomography/computed tomography: a new procedure to perform the sentinel node biopsy in patients with head and neck melanoma

Sentinel lymph node biopsy is accurate and prognostic in head and neck melanoma

Sentinel node-guided evaluation of drainage patterns for melanoma of the helix of the ear

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