Sentinel Node Dissection in the Treatment of Melanoma

COTTINGHAM, TERI J.; Larson, Jeannie T.; Delaney, John P.; Zachary, Christopher B.

doi:10.1111/j.1524-4725.1997.tb00671.x

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…As a matter of fact, intraoperative frozen section examination with H&E may miss occult nodal metastases for sampling error problems. Conversely, the complete examination of the entire lymph node by means of serial sectioning and immunohistochemical techniques or PCR for tyrosinase mRNA (a gene product specific to melanin-producing cells) can detect micrometastases in 16-30% of the sN which are judged negative by routine H&E staining; moreover, frozen section analysis might waste potentially diagnostic material that may contain micrometastases [28][29][30][31]. Tanis et al [32] examined 99 patients who underwent sN biopsy with frozen section examination, and reported a sensitivity of 47% (8 of 17), a specificity of 100% (82 of 82), and a negative predictive value of 90% (82 of 91); the benefit of frozen section examination in avoiding a twostage procedure was 7% (8 of 99).…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy in patients with Stage I/II melanoma: Clinical experience and literature review

Gipponi¹,

Somma²,

Peressini³

et al. 2004

Journal of Surgical Oncology

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Sentinel node lymphadenectomy can be better accomplished when both procedures (lymphatic mapping with Patent Blue-V and RGS) are used because the two methods look quite complementary. In fact, the use of the radiocolloid mapping allows to detect a hot spot in the regional basin prior to making the skin incision in order to perform a minimal invasive access, and it may also more accurately differentiate the true sN from a secondary echelon node (non-sN). The use of frozen section examination should be restricted to patients with pT(3)-pT(4) primary melanoma, due to the higher sensitivity and benefit in terms of avoiding a two-stage operative procedure.

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Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy in patients with Stage I/II melanoma: Clinical experience and literature review

Gipponi¹,

Somma²,

Peressini³

et al. 2004

Journal of Surgical Oncology

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“…In our patients, we observed no side effects to intradermal injection of vital blue dye and/or radiocolloid [19].…”

Section: Discussionmentioning

confidence: 53%

Sentinel node biopsy in patients with cutaneous melanoma

Cafiero

Peressini

Gipponi

et al. 1998

Semin. Surg. Oncol.

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“…A highly debated issue regarding sN biopsy concerns whether to perform intraoperative frozen-section examination (so as to select patients with sN metastasis to regional lymphadenectomy in a 'one-stage' procedure), or wait for definitive histopathological examination of the sN; usually (as a matter of fact), the therapeutic dissection is performed as the second phase of a 'two-stage' procedure (sN biopsy at first, followed by lymph node dissection a few days later as soon as the metastatic involvement of the sN is shown by histopathology examination using H&E and immunohistochemical staining) [25][26][27][28]. These two approaches also imply a different in-hospital management of patients undergoing sN biopsy, because the first step of a 'two-stage' procedure could be safely performed in a 'daysurgery' facility.…”

Section: Discussionmentioning

confidence: 99%

Predictive role of preoperative lymphoscintigraphy on the status of the sentinel lymph node in clinically node-negative patients with cutaneous melanoma

Solari¹,

Gipponi

Stella

et al. 2009

Melanoma Research

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We reviewed our experience to assess the predictive role of preoperative lymphoscintigraphy with regard to the pathological status of sentinel lymph node (sN) in patients with cutaneous melanoma, to optimize the surgical treatment planning with regard to the use of intraoperative frozen section examination of sN. Eighty-eight patients with clinically node-negative cutaneous melanoma pT1b-T4 stage underwent preoperative lymphoscintigraphy for the lymphatic mapping of sN. A lymphoscintigraphic 'score' (from L1 to L5) was developed based on the ratio of radiotracer concentration within sN nodes as compared with the injection site. Our score allowed us to foresee that sN of patients with thick melanomas (T3 and T4) and a low preoperative score (L1-L2-L3) had a 90% expected likelihood (P<0.001) of harboring metastasis, whereas sN in patients with thin melanomas (T1b-T2) and high preoperative score (from L4 to L5) showed a 100% likelihood of being metastasis free. In conclusion, the sN is a reliable predictor of regional lymph node status in patients with cutaneous malignant melanoma. Moreover, we suggest that a low score (L1-L2-L3) associated with a thick melanoma is a good predictive factor of the positive sN involvement. This information could be useful in scheduling the intraoperative frozen-section examination with an expected benefit of a positive test in almost 90% of patients. Such patients might be selected for a 'one-stage' procedure with a more effective cost/benefit ratio and decreased hospitalization costs.

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Sentinel Node Dissection in the Treatment of Melanoma

Abstract: Our preliminary findings in this limited series suggests that sentinel node dissection appears to be a procedure of low morbidity and relatively high predictive value.

Cited by 9 publications

References 24 publications

Sentinel lymph node biopsy in patients with Stage I/II melanoma: Clinical experience and literature review

Sentinel lymph node biopsy in patients with Stage I/II melanoma: Clinical experience and literature review

Sentinel node biopsy in patients with cutaneous melanoma

Predictive role of preoperative lymphoscintigraphy on the status of the sentinel lymph node in clinically node-negative patients with cutaneous melanoma

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