Abstract
Background: Sentinel lymph node (SLN) biopsy for head and neck (H&&N) melanomas may be more technically challenging compared with other locations because of complex lymphatic drainage patterns. This analysis was performed to compare the results of SLN biopsy for H&&N, truncal, and extremity melanomas.
Methods: The Sunbelt Melanoma Trial includes patients aged 18 to 70 with melanomas ≥1.0 mm thick. Statistical comparison was performed by χ2 or analysis of variance test.
Results: A total of 2610 patients were evaluated with a median follow-up of 18 months. The mean number of SLN per nodal basin was 2.8, 2.7, and 2.1 for H&&N, truncal, and extremity melanomas, respectively. Median Clark level, Breslow thickness, and percentage of ulceration were similar between the groups. Peri-parotid SLN was identified in 25% of cases; there were no facial nerve injuries. SLN biopsy for H&&N melanoma had higher false-negative rates at 1.5% (vs. 0.5% for trunk or extremity) but less histologically positive SLN at 15% (vs. 23.4%, and 19.5%; P &< .001) compared with truncal and extremity melanoma. Blue dye was visualized less frequently in SLN of H&&N melanoma patients compared with those with trunk or extremity melanomas.
Conclusions: Preoperative lymphoscintigraphy and meticulous intraoperative search for blue/radioactive nodes may improve results in H&&N melanomas.
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Chao, C., Wong, S.L., Edwards, M.J. et al. Sentinel Lymph Node Biopsy for Head and Neck Melanomas. Ann Surg Oncol 10, 21–26 (2003). https://doi.org/10.1245/ASO.2003.06.007
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DOI: https://doi.org/10.1245/ASO.2003.06.007