Sentinel Lymph Node Biopsy for Recurrent Melanoma: A Multicenter Study

被引:23
|
作者
Beasley, Georgia M. [1 ]
Hu, Yinin [2 ]
Youngwirth, Linda [3 ]
Scheri, Randall P. [3 ]
Salama, April K. [4 ]
Rossfeld, Kara [1 ]
Gardezi, Syed [2 ]
Agnese, Doreen M. [1 ]
Howard, J. Harrison [1 ]
Tyler, Douglas S. [5 ]
Slingluff, Craig L., Jr. [2 ]
Terando, Alicia M. [1 ]
机构
[1] Ohio State Univ, Wexner Med Ctr, Div Surg Oncol, Columbus, OH 43210 USA
[2] Univ Virginia, Div Surg Oncol, Charlottesville, VA USA
[3] Duke Univ, Dept Surg, Durham, NC USA
[4] Duke Univ, Div Med Oncol, Durham, NC USA
[5] Univ Texas Med Branch, Dept Surg, Galveston, TX 77555 USA
基金
美国国家卫生研究院;
关键词
EARLY-STAGE MELANOMA; AMERICAN JOINT COMMITTEE; ISOLATED LIMB PERFUSION; IN-TRANSIT METASTASES; MALIGNANT-MELANOMA; CUTANEOUS MELANOMA; PHASE-III; TNF-ALPHA; LYMPHADENECTOMY; TRIAL;
D O I
10.1245/s10434-017-5883-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Sentinel lymph node biopsy (SLNB) is routinely performed for primary cutaneous melanomas; however, limited data exist for SLNB after locally recurrent (LR) or in-transit (IT) melanoma. Methods. Data from three centers performing SLNB for LR/IT melanoma (1997 to the present) were reviewed, with the aim of assessing (1) success rate; (2) SLNB positivity; and (3) prognostic value of SLNB in this population. Results. The study cohort included 107 patients. Management of the primary melanoma included prior SLNB for 56 patients (52%), of whom 10 (18%) were positive and 12 had complete lymph node dissections (CLNDs). In the present study, SLNB was performed for IT disease (48/107, 45%) or LR melanoma (59/107, 55%). A sentinel lymph node (SLN) was removed in 96% (103/107) of cases. Nodes were not removed for four patients due to lymphoscintigraphy failures (2) or nodes not found during surgery (2). SLNB was positive in 41 patients (40%, 95% confidence interval (CI) 31.5-50.5), of whom 35 (88%) had CLND, with 13 (37%) having positive nonsentinel nodes. Median time to disease progression after LR/IT metastasis was 1.4 years (95% CI 0.75-2.0) for patients with a positive SLNB, and 5.9 years (95% CI 1.7-10.2) in SLNB-negative patients (p = 0.18). There was a trend towards improved overall survival for patients with a negative SLNB (p = 0.06). Conclusion. SLNB can be successful in patients with LR/IT melanoma, even if prior SLNB was performed. In this population, the rates of SLNB positivity and nonsentinel node metastases were 40% and 37%, respectively. SLNB may guide management and prognosis after LR/IT disease.
引用
收藏
页码:2728 / 2733
页数:6
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