Document Detail

Tumor-positive sentinel node biopsy of the groin in clinically node-negative melanoma patients: superficial or superficial and deep lymph node dissection?
MedLine Citation:
PMID:  18324444     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The extent of a completion groin dissection in sentinel node-positive melanoma patients was guided by the location of the second-echelon nodes on the preoperative lymphoscintigram. The purposes of the current study were to investigate the pathological findings, the lymph node recurrences and (disease-free) survival associated with this approach. METHODS: Between June 1996 and April 2007, 42 patients underwent completion groin dissection after a tumor-positive sentinel node biopsy. Eighteen patients had femoro-inguinal second-echelon nodes on their lymphoscintigram and underwent a superficial lymph node dissection. Twenty-four patients had iliac-obturator second-echelon nodes found by scan and underwent a combined superficial and deep dissection. RESULTS: The median follow-up time was 61 months. One of the 18 patients who underwent a superficial groin dissection developed a deep (obturator) lymph node recurrence after 12 months. Revision of the lymphoscintigram showed that the images had been interpreted incorrectly and that the second-echelon node was located in the obturator area after all. A combined superficial and deep dissection revealed additional involved nodes in the deep lymph node compartment in 2 of the 24 patients. At 5 years, 77% of all patients were alive, and 56% were alive and free of disease. These figures were 76% and 53%, respectively, in the patients who underwent superficial dissection only, and 80% and 61%, respectively, in the patients who also underwent deep dissection. CONCLUSIONS: This study suggests that a strategy to determine the extent of the groin dissection that is based on the location of the second-tier nodes may be valid.
Iris M C van der Ploeg; Renato A Valdés Olmos; Bin B R Kroon; Omgo E Nieweg
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Publication Detail:
Type:  Journal Article     Date:  2008-03-07
Journal Detail:
Title:  Annals of surgical oncology     Volume:  15     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-05-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1485-91     Citation Subset:  IM    
Department of Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
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MeSH Terms
Aged, 80 and over
Groin / pathology*,  radionuclide imaging,  surgery
Head and Neck Neoplasms / pathology,  radionuclide imaging,  surgery
Lymph Node Excision*
Lymph Nodes / pathology*,  radionuclide imaging,  surgery
Lymphatic Metastasis / radionuclide imaging
Melanoma / radionuclide imaging,  secondary*,  surgery
Middle Aged
Neoplasm Recurrence, Local / diagnosis*
Prospective Studies
Radiopharmaceuticals / diagnostic use
Sentinel Lymph Node Biopsy*
Skin Neoplasms / pathology*,  radionuclide imaging,  surgery
Survival Rate
Technetium Tc 99m Sulfur Colloid / diagnostic use
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Technetium Tc 99m Sulfur Colloid

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