Timing of sentinel lymph node biopsy and lymphoscintigraphy before surgery for melanoma: A systematic review and meta-analysis

被引：0
作者：
Wong, Zhen Yu [1 ]
Damavandi, Pegah [2 ]
Misky, Adam Tamas [3 ]
Pollock, Jonathan [3 ]
机构：
[1] Morriston Hosp, Dept Plast Surg, Swansea, Wales
[2] Univ Nottingham, Nottingham, England
[3] Nottingham City Hosp, Dept Plast Surg, Nottingham, England
来源：
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY | 2025年 / 101卷
关键词：
Sentinel lymph node biopsy; Melanoma; Lymphoscintigraphy; Systematic review; Timing; CUTANEOUS MELANOMA; SURVIVAL OUTCOMES;
D O I：
10.1016/j.bjps.2024.11.062
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Introduction: The management of malignant melanomas often involves performing a sentinel lymph node biopsy (SLNB) aided by imaging with lymphoscintigraphy. Whether lymphoscintigraphy should be performed on the same day as the SLNB operation (SD) or the day before (DB) surgery remains debated. This study aims to summarise existing evidence regarding the impact of the relative timings of lymphoscintigraphy and SLNB on clinical outcomes in melanoma. Methods: A PRISMA-compliant search was conducted from inception to 28th May 2024. Data were collected on SLNB in melanoma patients who underwent either an SD or DB approach. The following outcomes were extracted from the articles: node identification, recurrence rate and survival outcomes. Pooled effects of outcomes were estimated using the DerSimonian and Laird random-effects model/generalised linear mixed model, where applicable. Results: A total of 9 studies met the inclusion criteria. Six studies (n = 10, 216) compared SD and DB approach outcomes, while 3 studies (n = 153) compared SD and DB SLNB within the same patient cohort. In the former, no significant difference was found in positivity rates between SD and DB groups (RR 1.03, 95% CI 0.94-1.13, p = 0.475), and recurrence rates were comparable (RR 0.90, 95% CI 0.75-1.07, p = 0.233). SD approach was associated with significantly shorter hospital stays and lower costs, but conflicting results were observed in survival outcomes. In the latter studies, all 3 reported discrepancies between the results of the SD and DB approaches. Conclusion: Current evidence is insufficient to provide a definitive answer. Further research is warranted to conclusively evaluate the impact of SLNB timing on melanoma outcomes and patient care. Crown Copyright (c) 2024 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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页码：196 / 204
页数：9
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共 27 条
  • [1] Rughani M.G., Swan M.C., Adams T.S., Et al., Sentinel lymph node biopsy in melanoma: the Oxford ten year clinical experience, J Plast Reconstr Aesthet Surg, 64, 10, pp. 1284-1290, (2011)
  • [2] Morton D.L., Wen D.R., Wong J.H., Et al., Technical details of intraoperative lymphatic mapping for early stage melanoma, Arch Surg, 127, 4, pp. 392-399, (1992)
  • [3] Moncrieff M.D., O'Leary F.M., Beadsmoore C.J., Et al., Effect of delay between nuclear medicine scanning and Sentinel node biopsy on outcome in patients with cutaneous melanoma, Br J Surg, 107, 6, pp. 669-676, (2020)
  • [4] (2024)
  • [5] Faries M.B., Sentinel lymph nodes in melanoma: Necessary as ever for optimal treatment, Clin Exp Metastasis, 41, 4, pp. 369-374, (2024)
  • [6] Morton D.L., Thompson J.F., Cochran A.J., Et al., Final trial report of sentinel-node biopsy versus nodal observation in melanoma, N Engl J Med, 370, 7, pp. 599-609, (2014)
  • [7] Gershenwald J.E., Scolyer R.A., Hess K.R., Et al., Melanoma staging: evidence-based changes in the American Joint Committee on Cancer Eighth Edition Cancer Staging Manual, CA Cancer J Clin, 67, 6, pp. 472-492, (2017)
  • [8] Euscher E., Malpica A., Sentinel lymph nodes and vulvovaginal melanoma: comparison of Sentinel Lymph Node Protocols, Gynecol Oncol, 130, 1, pp. 150-151, (2013)
  • [9] Rodgaard J.C., Kramer S., Stolle L.B., Sentinel node biopsy (SNB) in malignant melanoma as same day procedure vs delayed procedure: clinical and economic outcome, J Plast Surg Hand Surg, 48, 4, pp. 265-269, (2014)
  • [10] Intenzo C.M., Truluck C.A., Kushen M.C., Kim S.M., Berger A., Kairys J.C., Lymphoscintigraphy in cutaneous melanoma: an updated total body Atlas of Sentinel Node mapping, Radiographics, 29, 4, pp. 1125-1135, (2009)
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