Sentinel lymph node biopsy for head and neck melanomas

Sentinel lymph node (SLN) biopsy for head and neck (H&N) melanomas may be more technically challenging compared with other locations because of complex lymphatic drainage patterns. This analysis was performed to compare the results of SLN biopsy for H&N, truncal, and extremity melanomas. The...

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Bibliographic Details
Published in:Annals of surgical oncology 2003-01, Vol.10 (1), p.21-26
Main Authors: Chao, Celia, Wong, Sandra L, Edwards, Michael J, Ross, Merrick I, Reintgen, Douglas S, Noyes, R Dirk, Stadelmann, Wayne K, Lentsch, Eric, McMasters, Kelly M
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Extremities
Female
Head and Neck Neoplasms - diagnostic imaging
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - surgery
Humans
Lymph Nodes - diagnostic imaging
Male
Melanoma - diagnostic imaging
Melanoma - pathology
Melanoma - surgery
Middle Aged
Neoplasm Recurrence, Local - pathology
Prospective Studies
Radionuclide Imaging
Sentinel Lymph Node Biopsy
Skin Neoplasms - diagnostic imaging
Skin Neoplasms - pathology
Skin Neoplasms - surgery
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Summary:Sentinel lymph node (SLN) biopsy for head and neck (H&N) melanomas may be more technically challenging compared with other locations because of complex lymphatic drainage patterns. This analysis was performed to compare the results of SLN biopsy for H&N, truncal, and extremity melanomas. The Sunbelt Melanoma Trial includes patients aged 18 to 70 with melanomas > or = 1.0 mm thick. Statistical comparison was performed by chi2 or analysis of variance test. A total of 2610 patients were evaluated with a median follow-up of 18 months. The mean number of SLN per nodal basin was 2.8, 2.7, and 2.1 for H&N, truncal, and extremity melanomas, respectively. Median Clark level, Breslow thickness, and percentage of ulceration were similar between the groups. Peri-parotid SLN was identified in 25% of cases; there were no facial nerve injuries. SLN biopsy for H&N melanoma had higher false-negative rates at 1.5% (vs. 0.5% for trunk or extremity) but less histologically positive SLN at 15% (vs. 23.4%, and 19.5%; P
ISSN:1068-9265
1534-4681
DOI:10.1245/ASO.2003.06.007