Sentinel Lymph Node Mapping with Radiocolloid in Malign Melanoma: Significance of Histopathological Findings in Follow up
Year 2024,
Volume: 4 Issue: 2, 1 - 9, 06.09.2024
Sibel Uçak Semirgin
,
Banu Kirtiloglu
Abstract
The presence of metastasis in regional lymph nodes has an essential value on survival in patients with malign melanoma. This study aimed to evaluate our experience on sentinel lymph node (SLN) mapping with radiocolloid in malign melanoma patients using SPECT/CT and present follow-up findings. Conventional planar lymphoscintigraphy and SPECT/CT images of 66 patients with primary cutaneous melanoma who underwent SLN biopsy in addition to the local primary excision or reexcision were retrospectively reviewed. All detected lymph nodes were removed and evaluated histopathologically. The number and histopathological findings of SLNs were determined, and follow-up findings of patients with metastatic or nonmetastatic nodes were comparedA statistically significant difference was not found in the number of detected SLN between planar and SPECT/CT imaging. The difference of total numbers of the metastatic and benign lymph nodes was statistically significant. A total of 55/66 patients were followed up with 10 months of median follow-up time and the presence of metastatic SLN on initial histopathological assessment was found to have a high risk for further metastatic disease. In the follow-up findings of 8/10 patients in whom SLN could not be detected on both planar and SPECT/CT imaging could be reached, normal findings were detected in 4 patients, and common nodal-visceral metastases in 4 patients. We concluded that, patients with malignant SLN histopathology had a high risk of developing metastases and should be followed up more frequently. As determined high metastases rate in patients with non-visualized SLN on radiocolloid imaging, it is essential to follow up also these patients meticulously.
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Year 2024,
Volume: 4 Issue: 2, 1 - 9, 06.09.2024
Sibel Uçak Semirgin
,
Banu Kirtiloglu
References
- Alazraki, N. P., Eshima, D., Eshima, L. A., Herda, S. C., Murray, D. R., Vansant, J. P., & Taylor, A. T. (1997). Lymphoscintigraphy, the sentinel node concept, and the intraoperative gamma probe in melanoma, breast cancer, and other potential cancers. Seminars in nuclear medicine, 27(1), 55–67. https://doi.org/10.1016/s0001-2998(97)80036-0
- Balch, C. M., Gershenwald, J. E., Soong, S. J., Thompson, J. F., Atkins, M. B., Byrd, D. R., Buzaid, A. C., Cochran, A. J., Coit, D. G., Ding, S., Eggermont, A. M., Flaherty, K. T., Gimotty, P. A., Kirkwood, J. M., McMasters, K. M., Mihm, M. C., Jr, Morton, D. L., Ross, M. I., Sober, A. J., & Sondak, V. K. (2009). Final version of 2009 AJCC melanoma staging and classification. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 27(36), 6199–6206. https://doi.org/10.1200/JCO.2009.23.4799
- Balch, C. M., Gershenwald, J. E., Soong, S. J., Thompson, J. F., Ding, S., Byrd, D. R., Cascinelli, N., Cochran, A. J., Coit, D. G., Eggermont, A. M., Johnson, T., Kirkwood, J. M., Leong, S. P., McMasters, K. M., Mihm, M. C., Jr, Morton, D. L., Ross, M. I., & Sondak, V. K. (2010). Multivariate analysis of prognostic factors among 2,313 patients with stage III melanoma: comparison of nodal micrometastases versus macrometastases. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 28(14), 2452–2459. https://doi.org/10.1200/JCO.2009.27.1627
- Benke, M., Wocial, K., Lewandowska, W., Rutkowski, P., Teterycz, P., Jarek, P., & Dedecjus, M. (2018). Value of planar lymphoscintigraphy (PL) versus SPECT/CT in evaluation of sentinel lymph node in trunk melanoma - one center, large series retrospective study. Nuclear medicine review. Central & Eastern Europe, 21(2), 79–84. https://doi.org/10.5603/NMR.a2018.0022
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- Hudak, K. A., Hudak, K. E., & Dzwierzynski, W. W. (2015). Sentinel lymph node biopsy for melanoma: is there a correlation of preoperative lymphatic mapping with sentinel lymph nodes harvested?. Annals of plastic surgery, 74(4), 462–466. https://doi.org/10.1097/SAP.0b013e3182a1e544
- Jansen, L., Nieweg, O. E., Kapteijn, A. E., Valdés Olmos, R. A., Muller, S. H., Hoefnagel, C. A., & Kroon, B. B. (2000). Reliability of lymphoscintigraphy in indicating the number of sentinel nodes in melanoma patients. Annals of surgical oncology, 7(8), 624–630. https://doi.org/10.1007/BF02725343
- Miller, M. W., Vetto, J. T., Monroe, M. M., Weerasinghe, R., Andersen, P. E., & Gross, N. D. (2011). False-negative sentinel lymph node biopsy in head and neck melanoma. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 145(4), 606–611. https://doi.org/10.1177/0194599811411878
- Morton, D. L., Wen, D. R., Wong, J. H., Economou, J. S., Cagle, L. A., Storm, F. K., Foshag, L. J., & Cochran, A. J. (1992). Technical details of intraoperative lymphatic mapping for early stage melanoma. Archives of surgery (Chicago, Ill. : 1960), 127(4), 392–399. https://doi.org/10.1001/archsurg.1992.01420040034005
- Morton, D. L., Thompson, J. F., Cochran, A. J., Mozzillo, N., Elashoff, R., Essner, R., Nieweg, O. E., Roses, D. F., Hoekstra, H. J., Karakousis, C. P., Reintgen, D. S., Coventry, B. J., Glass, E. C., Wang, H. J., & MSLT Group (2006). Sentinel-node biopsy or nodal observation in melanoma. The New England journal of medicine, 355(13), 1307–1317. https://doi.org/10.1056/NEJMoa060992
- Niebling, M. G., Pleijhuis, R. G., Bastiaannet, E., Brouwers, A. H., van Dam, G. M., & Hoekstra, H. J. (2016). A systematic review and meta-analyses of sentinel lymph node identification in breast cancer and melanoma, a plea for tracer mapping. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 42(4), 466–473. https://doi.org/10.1016/j.ejso.2015.12.007
- Pham Dang, N., Cassier, S., Mulliez, A., Mansard, S., DʼIncan, M., & Barthélémy, I. (2017). Eight Years' Experience of Sentinel Lymph Node Biopsy in Melanoma Using Lymphoscintigraphy and Gamma Probe Detection After Radiocolloid Mapping. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 43(2), 287–292. https://doi.org/10.1097/DSS.0000000000000961
- Sim, F. H., Taylor, W. F., Ivins, J. C., Pritchard, D. J., & Soule, E. H. (1978). A prospective randomized study of the efficacy of routine elective lymphadenectomy in management of malignant melanoma. Preliminary results. Cancer, 41(3), 948–956. https://doi.org/10.1002/1097-0142(197803)41:3<948::aid-cncr2820410324>3.0.co;2-z
- Stoffels, I., Boy, C., Pöppel, T., Kuhn, J., Klötgen, K., Dissemond, J., Schadendorf, D., & Klode, J. (2012). Association between sentinel lymph node excision with or without preoperative SPECT/CT and metastatic node detection and disease-free survival in melanoma. JAMA, 308(10), 1007–1014. https://doi.org/10.1001/2012.jama.11030
- Straver, M. E., Meijnen, P., van Tienhoven, G., van de Velde, C. J., Mansel, R. E., Bogaerts, J., Duez, N., Cataliotti, L., Klinkenbijl, J. H., Westenberg, H. A., van der Mijle, H., Snoj, M., Hurkmans, C., & Rutgers, E. J. (2010). Sentinel node identification rate and nodal involvement in the EORTC 10981-22023 AMAROS trial. Annals of surgical oncology, 17(7), 1854–1861. https://doi.org/10.1245/s10434-010-0945-z
- Tardelli, E., Mazzarri, S., Rubello, D., Gennaro, M., Fantechi, L., Duce, V., Romanini, A., Chondrogiannis, S., Volterrani, D., Colletti, P. M., & Manca, G. (2016). Sentinel Lymph Node Biopsy in Cutaneous Melanoma: Standard and New Technical Procedures and Clinical Advances. A Systematic Review of the Literature. Clinical nuclear medicine, 41(12), e498–e507. https://doi.org/10.1097/RLU.0000000000001370
- Thompson, J. F., Uren, R. F., Shaw, H. M., McCarthy, W. H., Quinn, M. J., O'Brien, C. J., & Howman-Giles, R. B. (1999). Location of sentinel lymph nodes in patients with cutaneous melanoma: new insights into lymphatic anatomy. Journal of the American College of Surgeons, 189(2), 195–204. https://doi.org/10.1016/s1072-7515(99)00108-8
- Wong, S. L., Balch, C. M., Hurley, P., Agarwala, S. S., Akhurst, T. J., Cochran, A., Cormier, J. N., Gorman, M., Kim, T. Y., McMasters, K. M., Noyes, R. D., Schuchter, L. M., Valsecchi, M. E., Weaver, D. L., Lyman, G. H., American Society of Clinical Oncology, & Society of Surgical Oncology (2012). Sentinel lymph node biopsy for melanoma: American Society of Clinical Oncology and Society of Surgical Oncology joint clinical practice guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 30(23), 2912–2918. https://doi.org/10.1200/JCO.2011.40.3519