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Polish Journal of Surgery

The Journal of Foundation of the Polish Journal of Surgery

12 Issues per year


CiteScore 2016: 0.29

SCImago Journal Rank (SJR) 2016: 0.166
Source Normalized Impact per Paper (SNIP) 2016: 0.207

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0032-373X
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Volume 80, Issue 5 (May 2008)

Issues

Sentinel Lymph Node Biopsy in Cutaneous Melanoma - Analysis of 227 Cases

Arkadiusz Spychała
  • Department of Oncological and General Surgery I, Wielkopolska Cancer Center, Poznań, Ordynator: prof. dr hab. P. Murawa
/ Dawid Murawa
  • Department of Oncological and General Surgery I, Wielkopolska Cancer Center, Poznań, Ordynator: prof. dr hab. P. Murawa
/ Karol Połom
  • Department of Oncological and General Surgery I, Wielkopolska Cancer Center, Poznań, Ordynator: prof. dr hab. P. Murawa
/ Andrzej Gracz
  • Department of Oncological and General Surgery I, Wielkopolska Cancer Center, Poznań, Ordynator: prof. dr hab. P. Murawa
/ Paweł Murawa
  • Department of Oncological and General Surgery I, Wielkopolska Cancer Center, Poznań, Ordynator: prof. dr hab. P. Murawa
Published Online: 2008-06-09 | DOI: https://doi.org/10.2478/v10035-008-0031-4

Sentinel Lymph Node Biopsy in Cutaneous Melanoma - Analysis of 227 Cases

The aim of the study was to evaluate the experience of the centre in carrying out and assessing the use of sentinel node biopsy in skin melanoma.

Material and methods. From 2000 to 2004, a sentinel node biopsy was carried out on 227 patients being treated for skin melanoma. In all the patients, the sentinel node was subjected to a standard histological evaluation with the application of H+E staining. If no melanoma cells were visualised within the sentinel node, the material was subjected to an immunohistochemical investigation. The patients whose sentinel node included metastases found in the H+E examination or micrometastases identified by means of the immunohistochemical investigation were subjected to a supplementary lymphadenectomy.

Results. The sentinel node was identified in all the patients. In a group of 28 patients (12.3%), the presence of metastases within the sentinel node was visualised by means of H+E examination. A group of 199 patients (87.66%) with a metastases-negative sentinel node (H+E staining) was subjected to immunohistochemical evaluation, which revealed the presence of micrometastases in 45 patients (19.82%). Supplementary lymphadenectomy was carried out in patients who screened positive, and metastases were identified in other regional lymph nodes in 11 (4.8%) patients.

Conclusions. 1. After finishing the learning curve, the sentinel node biopsy is a simple and effective method, enabling precise assessment of the lymphatic system in patients with skin melanoma. 2. The application of immunohistochemical investigation enabled the identification of micrometastases in 19.8% of the patients, where these were not found in the H+E examination. 3. The application of sentinel node biopsy allowed lymphadenectomy to be avoided in 154 (67.8%) patients.

Keywords: sentinel node; skin melanoma

  • Zogakis T, Essner R, Wang H et al.: Natural history of melanoma in 733 patients with tumor-negative sentinel lymph nodes. Ann Surg Oncol 2007; 14(5): 1604-11.Google Scholar

  • Ruka W: Onkologia kliniczna. Krzakowski M (red) Wyd. 2, Borigs, Warszawa 2006.Google Scholar

  • Godlewski D: Nowotwory złośliwe w Wielkopolsce. Agencja BAS - Biuro Analiz Społecznych 1998.Google Scholar

  • Morton D, Wanek L, Nizze J et al.: Improved long-term survival after lymphadenectomy of melanoma metastatic to regional nodes: analysis of prognostic factors in 1134 patients form John Wayne Cancer Clinic Ann Surg 1991; 214: 491-99.Google Scholar

  • Balch C, Soong S, Gershenwald J 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.Google Scholar

  • Lee J, Essner R, Torisu-Itakura H et al.: Factors predictive of tumor-positive nonsentinel lymph nodes after tumor-positive sentinel lymph node dissection for melanoma. J Clin Oncol 2004; 22: 3677-84.CrossrefPubMedGoogle Scholar

  • Gershenwald J, Thompson W, Mansfield P et al.: Multiinstitutional 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.Google Scholar

  • Estourgie S, Nieweg O, Valdes Olmos E et al.: Review and evaluation of sentinel node procedur es in 250 melanoma patients with a median follow-up of 6 years. Ann Surg Oncol 2003; 10(6): 681-88.Google Scholar

  • Karakousis C, Grigoropoulos P: Sentinel node biopsy before and after wide excision of the primary melanoma. Ann Surg Oncol 1999; 6(8): 785-89.CrossrefPubMedGoogle Scholar

  • Morton L, Cochran A, Thompson J et al.: Sentinel node biosy for early-stage melanoma accuracy and morbidiry in MSTL-I, an international multicenter trial. Ann Surg 2005; 242: 302-11.Web of ScienceGoogle Scholar

  • Vidal-Sicart S, Pons F, Puig S et al.: Identification of the sentinel node in patients with malignant melanoma: what are the reasons for mistakes? Eur J Nucl Med 2003; 30: 362-66.CrossrefGoogle Scholar

  • Van Diest PJ: Histopathological workup of sentinel lymp nodes: how much is enough? J Clin Pathol 1999; 52: 871-73.CrossrefGoogle Scholar

  • Spanknebel K, Coit D, Bieligk S et al.: Characterization of micrometastatic disease in melanoma sentinel lymph nodes by enhanced pathology. Am J Surg Pathol 2005; 29: 305-17.PubMedCrossrefGoogle Scholar

  • Duprat J, Debora C, Silva P et al.: Sentinel lymph node biosy in cutaneous melanoma: Analysis of 240 consecutive cases. Plat and recon surg 2005; 115(7): 1944-51.Google Scholar

  • Cochran A, Wen D, Herschman H: Occult melanoma in lymph nodes detected by antiserum to S-100 protein. Int J Cancer 1984; 34: 159-63.CrossrefGoogle Scholar

  • Van Akkooi AC, de Wilt JH, Verhoef C et al.: Clinical relevance of melanoma micrometastases (7lt;0.1 mm) in sentinel nodes: are these nodes to be considered negative? Ann Oncol 2006; 17(10): 1578-85.Google Scholar

  • Govindarajan A, Ghazarian DM, McCready DR et al.: Histological features of melanoma sentinel lymph node metastases associated with status of the completion lymphadenectoy and rate of subsequent relapse. Ann Surg Oncol 2007; 14(2): 906-12.Web of ScienceCrossrefGoogle Scholar

  • Scheri R, Essner R, Turner R et al.: Isolated tumor cells in the sentinel node affect long-term prognosis of patients with melanoma. Ann Surg Oncol 2007; 14(10): 2861-66.PubMedGoogle Scholar

  • Morton L, Thompson J, Cochran A et al.: Sentinel-node biosy or nodal observation in melanoma. N Engl J Med 2006; 355: 1307-17.Google Scholar

  • Wong S, Morton D, Thompson J et al.: Melanoma patietns with positive sentinel nodes who did not undergo completion lymphadenecotmy: A Multi-Institutional Study. Ann Surg Oncol 2005; 13(6): 809-16.Google Scholar

  • Caraco C, Marone U, Celentano E et al.: Impact of false-negative sentinel lymph node biosy on survival in patients with cutaneous mealoma. Ann Surg Oncol 2007; 14(9): 2662-67.CrossrefGoogle Scholar

About the article


Published Online: 2008-06-09

Published in Print: 2008-05-01


Citation Information: Polish Journal of Surgery, ISSN (Print) 0032-373X, DOI: https://doi.org/10.2478/v10035-008-0031-4.

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