Outcome of Patients With Melanoma and Histologically Negative Sentinel Lymph Nodes

Gadd, Michele A.; Cosimi, A. Benedict; Yu, JiaDe; Duncan, Lyn M.; Yu, Lawrence; Flotte, Thomas J.; Souba, Wiley W.; Ott, Mark J.; Wong, Lisa S.; Sober, Arthur J.; Mihm, Martín C.; Haluska, Frank G.; Tanabe, Kenneth K.

doi:10.1001/archsurg.134.4.381

Cited by 147 publications

(83 citation statements)

References 18 publications

(27 reference statements)

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“…Furthermore, previous studies involving melanomas from all anatomic sites showed a statistically significant improvement in survival in patient with intermediate thickness melanomas (range, 1-4 mm), which suggests that some subgroups of patients may benefit from ELND 3,25,31 . Finally, despite the fact that sentinel lymph node biopsy (SLNB) has been adopted into clinical practice as reliable staging modality, there are lots of arguments against it, such as increased incidence of nodal (regional and in-transit) recurrence in sentinel lymph nodes (SLN) negative patients, possibility of false-negative results, difficult identification of SLN if they are located close to primary site, SLN found in multiple node fields in contrast to melanomas located on extremities which usually drain to only 1 field, SLN in parotid region which are often very small, may be difficult to find, and their removal may put the facial nerve at risk 8,10,12,15,16,29,36,37 . However, some authors reported that intraparotid SLN biopsy is a reliable, accurate, and safe procedure for staging cutaneous head and neck melanoma 23 .…”

Section: Discussionmentioning

confidence: 99%

Lymphatic drainage patterns of head and neck cutaneous melanoma: does primary melanoma site correlate with anatomic distribution of pathologically involved lymph nodes?

Suton¹,

Lukšić²,

Müller³

et al. 2012

International Journal of Oral and Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Lymphatic drainage patterns of head and neck cutaneous melanoma: does primary melanoma site correlate with anatomic distribution of pathologically involved lymph nodes?

Suton¹,

Lukšić²,

Müller³

et al. 2012

International Journal of Oral and Maxillofacial Surgery

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“…With long-term follow-up of patients with negative sentinel nodes there is a small but definite incidence of recurrence in the mapped and sampled nodal basin. 5,[10][11][12][13][14][15][16][17][18][19] These patients may be considered to have a false-negative result of their sentinel node biopsy procedure. Previous reports have suggested that the majority of patients who recur in the relevant node field will, in fact, have identifiable metastases in the biopsied sentinel node if a more comprehensive histopathologic evaluation of the node is undertaken.…”

Section: Discussionmentioning

confidence: 99%

“…With long-term follow-up of patients with negative sentinel nodes, some develop a recurrence in the mapped and sampled nodal basin and these patients may be considered to have a false-negative result of their sentinel node biopsy procedure. A technique to confirm true sentinel node identity may reduce the false-negative rate of the procedure, which has been disappointingly high (up to 44%) in several recently reported studies, 5,[10][11][12][13][14][15][16][17][18][19] or at least provide a retrospective explanation for a falsenegative result.…”

mentioning

confidence: 99%

Antimony concentrations in nodal tissue can confirm sentinel node identity

Scolyer

Thompson

et al. 2004

Modern Pathology

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The sentinel node biopsy procedure is a highly accurate method of staging patients with cutaneous melanoma and the tumor-harboring status of sentinel nodes is the most important prognostic factor. For the procedure to provide accurate prognostic information, however, it is essential that 'true' sentinel nodes are removed and examined thoroughly. A technique to confirm sentinel node identity may reduce the false-negative rate of the procedure. We have found that antimony (originating from the antimony sulfide colloid used for preoperative lymphoscintigraphy in our institution) can be measured in tissue sections of sentinel nodes using inductively coupled plasma mass spectrometry. The aims of this study were to determine whether antimony concentrations can be used to confirm that removed sentinel nodes are 'true' sentinel nodes and to differentiate sentinel nodes from nonsentinel nodes. In all, 24 patients who had both a tumor-positive sentinel node and a tumor-negative nonsentinel node removed from one regional node field during the same operation, were identified. Tissue sections (50 lm) thick were cut from archival paraffin blocks of each of the sentinel nodes and nonsentinel nodes. Antimony concentrations in the tissue sections were measured using inductively coupled plasma mass spectrometry. The median and mean concentrations of antimony in parts per billion were 0.526 and 1.198, respectively (range 0.020-7.596) in the sentinel nodes, and 0.043 and 0.123 (range 0-0.800) in the nonsentinel nodes (P ¼ 0.004). In four of the 24 pairs, both the presumed sentinel nodes and the nonsentinel nodes had very low antimony levels (less than 0.18 parts per billion), suggesting that nodes designated as sentinel nodes may not have been 'true' sentinel nodes. It is concluded that determination of antimony concentrations within sentinel nodes using the highly sensitive method of inductively coupled plasma mass spectrometry can confirm the identity of sentinel nodes and validate the sentinel node technique.

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“…The predominant treatment for primary melanoma is wide local excision; however, even patients treated with surgical resection are at a high risk of nodal and distant metastases [11,37]. In addition, MM is generally resistant to conventional therapies such as systemic chemotherapy and radiotherapy [5]; therefore, MM carries a poor prognosis [10].…”

Section: Introductionmentioning

confidence: 99%

Oral Administration of Immunopotentiator from Pantoea agglomerans 1 (IP-PA1) Improves the Survival of B16 Melanoma-Inoculated Model Mice

et al. 2011

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Abstract:To investigate the usefulness of the immunopotentiator from Pantoea agglomerans 1 (IP-PA1) as a supportive drug in melanoma therapy, we analyzed the immunological effects of IP-PA1 on melanoma-inoculated model mice. Oral administration of IP-PA1 increased the serum levels of tumor necrosis factor (TNF)-α at 2 h after the administration and interferon (IFN)-γ and IL-12 at 12 h after the administration in naïve BALB/cCrSlc mice as evaluated by ELISA. IP-PA1 did not affect the proliferation of melanoma cells directly determined by the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay. Combinatory treatment of IP-PA1 with doxorubicin for 9 days increased the serum levels of IFN-γ and IL-12 by 71.0 and 15.3%, respectively, compared to the treatment of doxorubicin alone in melanoma-bearing C57BL/6NCrSlc mice as evaluated by ELISA. It also increased the proportion of natural killer (NK) cells and the ratio of CD4 + to CD8 + T cells in the spleen from 6.1 ± 0.3 to 7.4 ± 0.5% and from 1.25 ± 0.03 to 1.38 ± 0.04, respectively, compared to the treatment of doxorubicin alone as analyzed by flow cytometry. The mean survival period of melanoma-bearing, doxorubicin treated mice was prolonged from 31.4 ± 7.1 to 35.3 ± 8.4, 51.1 ± 5.4, and 45.0 ± 8.4 days by combinatory treatment of IP-PA1 at the daily doses of 0.1, 0.5, and 1 mg/kg, respectively. In conclusion, the results of the present study suggest the usefulness of IP-PA1 as a supportive drug in melanoma therapy.

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Outcome of Patients With Melanoma and Histologically Negative Sentinel Lymph Nodes

Cited by 147 publications

References 18 publications

Lymphatic drainage patterns of head and neck cutaneous melanoma: does primary melanoma site correlate with anatomic distribution of pathologically involved lymph nodes?

Lymphatic drainage patterns of head and neck cutaneous melanoma: does primary melanoma site correlate with anatomic distribution of pathologically involved lymph nodes?

Antimony concentrations in nodal tissue can confirm sentinel node identity

Oral Administration of Immunopotentiator from Pantoea agglomerans 1 (IP-PA1) Improves the Survival of B16 Melanoma-Inoculated Model Mice

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