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Adequacy of sentinel lymph node biopsy in malignant melanoma of the trunk and extremities: Clinical observations regarding prognosis

  • Bae, Yong Chan (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Jeong, Dae Kyun (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Kim, Kyoung Hoon (Brand Plastic Surgery) ;
  • Nam, Kyung Wook (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Kim, Geon Woo (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Kim, Hoon Soo (Department of Dermatology, Pusan National University School of Medicine) ;
  • Nam, Su Bong (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Bae, Seong Hwan (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
  • Received : 2019.07.20
  • Accepted : 2019.10.18
  • Published : 2020.01.15

Abstract

Background Methods for identifying local lymph node metastasis in malignant melanoma include sentinel lymph node biopsy (SLNB) and lymph node dissection (LND). In particular, SLNB has been widely used in recent years. This study aimed to retrospectively confirm the adequacy of the current indication criteria for SLNB by applying those criteria to a mixed group of patients who previously received SLNB and LND. Methods This study included 77 patients with malignant melanoma of the extremities and trunk who were monitored for >24 months. The patients were classified according to whether the current indication criteria for SLNB were applicable. The sentinel lymph nodes were evaluated for each group. Patients for whom the indication criteria for SLNB and LND were applicable were analyzed according to whether SLNB or LND was performed. Finally, the outpatient records of these patients were reviewed to evaluate recurrence, metastasis, and prognosis. Results Of the 77 patients, SLNB was indicated according to the current criteria in 60 cases. Among the 60 patients for whom SLNB was indicated, 35 survived the follow-up period disease-free, 21 died during the follow-up period, and four experienced metastasis. The 17 patients for whom SLNB was not indicated had no recurrence or metastasis. Conclusions Patients for whom SLNB was not indicated had no recurrence or metastasis. In cases where SLNB is indicated, the possibility of metastasis and recurrence may be high even if SLNB is negative or LND is performed, so more aggressive treatment and careful follow-up are crucial.

Keywords

References

  1. Gershenwald JE, Thompson W, Mansfield PF, et al. Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients. J Clin Oncol 1999;17:976-83. https://doi.org/10.1200/JCO.1999.17.3.976
  2. Balch CM, Soong SJ, Gershenwald JE, et al. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol 2001;19:3622-34. https://doi.org/10.1200/JCO.2001.19.16.3622
  3. Morton DL, Wanek L, Nizze JA, et al. Improved long-term survival after lymphadenectomy of melanoma metastatic to regional nodes: analysis of prognostic factors in 1134 patients from the John Wayne Cancer Clinic. Ann Surg 1991; 214:491-9. https://doi.org/10.1097/00000658-199110000-00013
  4. McMasters KM, Chao C, Wong SL, et al. Interval sentinel lymph nodes in melanoma. Arch Surg 2002;137:543-7. https://doi.org/10.1001/archsurg.137.5.543
  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. https://doi.org/10.1001/archsurg.1992.01420040034005
  6. Rousseau DL Jr, Ross MI, Johnson MM, et al. Revised American Joint Committee on Cancer staging criteria accurately predict sentinel lymph node positivity in clinically node-negative melanoma patients. Ann Surg Oncol 2003; 10:569-74. https://doi.org/10.1245/ASO.2003.09.016
  7. Ali-Salaam P, Ariyan S. Lymphatic mapping and sentinel lymph node biopsies. Clin Plast Surg 2000;27:421-9. https://doi.org/10.1016/S0094-1298(20)32737-1
  8. Balch CM, Gershenwald JE, Soong SJ, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 2009;27:6199-206. https://doi.org/10.1200/JCO.2009.23.4799
  9. Johnson DS, Yamane S, Morita S, et al. Malignant melanoma in non-Caucasians: experience from Hawaii. Surg Clin North Am 2003;83:275-82. https://doi.org/10.1016/S0039-6109(02)00093-2
  10. Qiu D, Marugame T. Comparison of time trends in skin cancer incidence (1973-97) in East Asia, Europe and USA, from cancer incidence in five continents vol. IV-VIII. Jpn J Clin Oncol 2008;38:234-6. https://doi.org/10.1093/jjco/hyn012
  11. Socrier Y, Lauwers-Cances V, Lamant L, et al. Histological regression in primary melanoma: not a predictor of sentinel lymph node metastasis in a cohort of 397 patients. Br J Dermatol 2010;162:830-4. https://doi.org/10.1111/j.1365-2133.2009.09606.x
  12. Roh MR, Kim J, Chung KY. Treatment and outcomes of melanoma in acral location in Korean patients. Yonsei Med J 2010;51:562-8. https://doi.org/10.3349/ymj.2010.51.4.562
  13. Lee HY, Chay WY, Tang MB, et al. Melanoma: differences between Asian and Caucasian patients. Ann Acad Med Singapore 2012;41:17-20.
  14. Nam KW, Bae YC, Bae SH, et al. Analysis of the clinical and histopathological patterns of 100 consecutive cases of primary cutaneous melanoma and correlation with staging. Arch Plast Surg 2015;42:746-52. https://doi.org/10.5999/aps.2015.42.6.746
  15. Nam KW, Bae YC, Nam SB, et al. Characteristics and treatment of cutaneous melanoma of the foot. Arch Plast Surg 2016;43:59-65. https://doi.org/10.5999/aps.2016.43.1.59
  16. Carlson GW, Page AJ, Cohen C, et al. Regional recurrence after negative sentinel lymph node biopsy for melanoma. Ann Surg 2008;248:378-86. https://doi.org/10.1097/SLA.0b013e3181855718
  17. Yee VS, Thompson JF, McKinnon JG, et al. Outcome in 846 cutaneous melanoma patients from a single center after a negative sentinel node biopsy. Ann Surg Oncol 2005;12:429-39. https://doi.org/10.1245/ASO.2005.03.074
  18. Wagner JD, Corbett L, Park HM, et al. Sentinel lymph node biopsy for melanoma: experience with 234 consecutive procedures. Plast Reconstr Surg 2000;105:1956-66. https://doi.org/10.1097/00006534-200005000-00007
  19. Morton DL, Cochran AJ, Thompson JF, et al. Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg 2005; 242:302-11. https://doi.org/10.1097/00000658-200509000-00002
  20. Thompson JF, Hunt JA, Culjak G, et al. Popliteal lymph node metastasis from primary cutaneous melanoma. Eur J Surg Oncol 2000;26:172-6. https://doi.org/10.1053/ejso.1999.0765
  21. Menes TS, Schachter J, Steinmetz AP, et al. Lymphatic drainage to the popliteal basin in distal lower extremity malignant melanoma. Arch Surg 2004;139:1002-6. https://doi.org/10.1001/archsurg.139.9.1002
  22. Kim HY, Chang H, Minn KW. Popliteal lymph node dissection in lower extremity malignant melanoma. J Korean Soc Plast Reconstr Surg 2009;36:485-8.