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Abstract
Purpose
Sentinel lymph node (SLNB) is the first confronted lymph node from primary lesion of tumor through lymphatic drainage, which is important for determining early metastasis and setting guidelines for treatment. We reported significant of sentinel lymph node biopsy in malignant melanoma (MM) and squamous cell carcinoma (SCC) of lower extremities.
Materials and Methods
Twenty-five cases of surgically treatment and being possible for follow up more than 1 year among the patients who were diagnosed as MM and SCC in this institution from Sep. 2005 to Jan. 2009, and 10 cases of them were performed SLNB. Average age was 64 years old, and 15 cases of male and 10 cases of female were in this group.
Results
3 years overall survival rate was 100% and 3 years disease-free survival rate was 76%. Metastasis occurred in total 6 patients, 4 cases of inguinal lymph nodes, 1 case of soft tissue around knee, 1 case of left achilles tendon. In 15 cases of not performing SLNB, overall survival rate was 93.3% and disease-free survival rate was 73.3%. In 10 cases of performing SLNB, overall survival rate was 100% and disease-free survival rate was 90%. And only 1 case showed positive finding in the biopsy, and none of the 10 cases showed metastasis in followup.
Conclusion
SLNB leads simpler and less complications compared to prior elective lymph node dissection, and shows high degree of accuracy. Throughout the SLNB, setting guidelines for treatment by accurate staging is thought to be helpful for increasing the survival rate in the patient with MM and SCC.
REFERENCES
1. Alam M, Ratner D. Cutaneous squamous cell carcinoma. N Engl J Med. 2001; 344:975–83.
2. Ross AS, Schmults CD. Sentinel lymph node biopsy in cutaneous squamaous cell carcinoma: a systematic review of the English literature. Dermatol Surg. 2006; 32:1309–21.
3. Roka F, Kittler H, Cauzig P, et al. Sentinel node status in melanoma patients is not predictive for overall survival upon mul-tivatiate analysis. Br J Cancer. 2005; 92:662–7.
4. Morton DL, Cagle L, Wong J. Intraoperative lymphatic mapping and selective lymphadenectomy: technical details of a new procedure for clinical stage I melanoma. Presented at the 42nd Annual Meeting of the Society of Surgical Oncology, Washington DC;. 1990.
5. Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992; 127:392–9.
6. Kwon YH, Kim JR, Lee YG, Kim JD. Analysis of treatment and prognosis in malignant melanoma. J Korean Bone Joint Tumor Soc. 2005; 11:141–7.
7. Cochran AJ, Essner R, Ross DM, et al. Principles of sentinel lymph node identification: background and clinical implications. Langenbecks Arch Surg. 2000; 385:252–60.
8. Balch CM, Milton GW, Cascinelli N, et al. Elective lymph node dissection: pros and cons. Cutaneous melanoma. 2nd ed.Philadelphia: Lippincott;1992. p. 345–66.
9. Sim FH, Taylor WF, Pritchard DJ, et al. Lymphadenectomy in the management of Stage I malignant melanoma: a prospective randomized study. Mayo Clin Proc. 1986; 61:697–705.
10. Chen SL, Iddings DM, Scheri RP, et al. Lymphatic mapping and sentinel node analysis: current concepts and applications. CA Cancer J Clin. 2006; 56:292–309.
11. Thompson JF, Uren RF. Teaching points on lymphatic mapping for melanoma from the Sydney Melanoma Unit. Semin Oncol. 2004; 31:349–56.
12. Veronesi U, Adamus J, Bandiera DC, et al. Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities. Cancer. 1982; 49:2420–30.
13. Uren RF, Howman-Giles RB, Thompson JF. Demonstration of second-tier lymph nodes during preoperative lymphoscintigraphy. Ann Surg Oncol. 1998; 5:517–21.
14. Morton DL, Cochran AJ, Thompson JF, et al. Sentinel node biopsy for early-stage melanoma accuracy and morbidity in MSLT-1, an international multicenter trial. Ann Surg. 2005; 242:302–11.
15. Robinson DS, Sample WF, Fee HJ, et al. Regional lymphatic drainage in primary malignant melanoma of the trunk determined by colloidal gold scanning. Surg Forum. 1977; 28:147–8.
16. McMasters KM, Chao C, Wong SL, et al. Interval sentinel lymph nodes in melanoma. Arch Surg. 2002; 137:543–7.
17. Glass EC, Essner R, Morton DL. Kinetics of three lymphoscin-tigraphic agents in patients with cutaneous melanoma. J Nucl Med. 1998; 39:1185–90.
18. Haigh PI, Lucci A, Turner RR, et al. Carbon dye histologically confirms the identify of sentinel lymph nodes in cutaneous melanoma. Cancer. 2001; 92:535–41.
19. Renzi C, Caggiati A, Mannooranparampil TJ, et al. Sentinel lymph node biopsy for high risk cutaneous squamous cell carcinoma: case series and review of the literature. Eur J Surg Oncol. 2007; 33:364–9.
20. Bagaria SP, Faries MB, Morton DL. Sentinel node biopsy in melanoma: technical consideration of the procedure as performed at the John Wayne Cancer institute. J Surg Oncol. 2010; 101:669–76.
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