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Efficacy of repeat sentinel lymph node biopsy in patients who develop recurrent melanoma.

Publication ,  Journal Article
Beasley, GM; Speicher, P; Sharma, K; Seigler, H; Salama, A; Mosca, P; Tyler, DS
Published in: J Am Coll Surg
April 2014

BACKGROUND: Even after negative sentinel lymph node biopsy (SLNB) for primary melanoma, patients who develop in-transit (IT) melanoma or local recurrences (LR) can have subclinical regional lymph node involvement. STUDY DESIGN: A prospective database identified 33 patients with IT melanoma/LR who underwent technetium 99m sulfur colloid lymphoscintigraphy alone (n = 15) or in conjunction with lymphazurin dye (n = 18) administered only if the IT melanoma/LR was concurrently excised. RESULTS: Seventy-nine percent (26 of 33) of patients undergoing SLNB in this study had earlier removal of lymph nodes in the same lymph node basin as the expected drainage of the IT melanoma or LR at the time of diagnosis of their primary melanoma. Lymphoscintography at time of presentation with IT melanoma/LR was successful in 94% (31 of 33) cases, and at least 1 sentinel lymph node was found intraoperatively in 97% (30 of 31) cases. The SLNB was positive in 33% (10 of 30) of these cases. Completion lymph node dissection was performed in 90% (9 of 10) of patients. Nine patients with negative SLNB and IT melanoma underwent regional chemotherapy. Patients in this study with a positive sentinel lymph node at the time the IT/LR was mapped had a considerably shorter time to development of distant metastatic disease compared with those with negative sentinel lymph nodes. CONCLUSIONS: In this study, we demonstrate the technical feasibility and clinical use of repeat SLNB for recurrent melanoma. Performing SLNB cannot only optimize local, regional, and systemic treatment strategies for patients with LR or IT melanoma, but also appears to provide important prognostic information.

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Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

April 2014

Volume

218

Issue

4

Start / End Page

686 / 692

Location

United States

Related Subject Headings

  • Surgery
  • Skin Neoplasms
  • Sentinel Lymph Node Biopsy
  • Prognosis
  • Neoplasm Recurrence, Local
  • Melanoma
  • Lymphoscintigraphy
  • Lymphatic Metastasis
  • Lymph Node Excision
  • Kaplan-Meier Estimate
 

Citation

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Chicago
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Beasley, G. M., Speicher, P., Sharma, K., Seigler, H., Salama, A., Mosca, P., & Tyler, D. S. (2014). Efficacy of repeat sentinel lymph node biopsy in patients who develop recurrent melanoma. J Am Coll Surg, 218(4), 686–692. https://doi.org/10.1016/j.jamcollsurg.2013.12.025
Beasley, Georgia M., Paul Speicher, Ketan Sharma, Hilliard Seigler, April Salama, Paul Mosca, and Douglas S. Tyler. “Efficacy of repeat sentinel lymph node biopsy in patients who develop recurrent melanoma.J Am Coll Surg 218, no. 4 (April 2014): 686–92. https://doi.org/10.1016/j.jamcollsurg.2013.12.025.
Beasley GM, Speicher P, Sharma K, Seigler H, Salama A, Mosca P, et al. Efficacy of repeat sentinel lymph node biopsy in patients who develop recurrent melanoma. J Am Coll Surg. 2014 Apr;218(4):686–92.
Beasley, Georgia M., et al. “Efficacy of repeat sentinel lymph node biopsy in patients who develop recurrent melanoma.J Am Coll Surg, vol. 218, no. 4, Apr. 2014, pp. 686–92. Pubmed, doi:10.1016/j.jamcollsurg.2013.12.025.
Beasley GM, Speicher P, Sharma K, Seigler H, Salama A, Mosca P, Tyler DS. Efficacy of repeat sentinel lymph node biopsy in patients who develop recurrent melanoma. J Am Coll Surg. 2014 Apr;218(4):686–692.
Journal cover image

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

April 2014

Volume

218

Issue

4

Start / End Page

686 / 692

Location

United States

Related Subject Headings

  • Surgery
  • Skin Neoplasms
  • Sentinel Lymph Node Biopsy
  • Prognosis
  • Neoplasm Recurrence, Local
  • Melanoma
  • Lymphoscintigraphy
  • Lymphatic Metastasis
  • Lymph Node Excision
  • Kaplan-Meier Estimate