Complete lymphadenectomy following positive sentinel lymph node biopsy in cutaneous melanoma: a critical review
AUTOR(ES)
Eiger, Daniel, Oliveira, Daniel Arcuschin de, Oliveira, Renato Leão de, Sousa, Murilo Costa, Brandão, Mireille Darc Cavalcante, Oliveira Filho, ,Renato Santos de
FONTE
An. Bras. Dermatol.
DATA DE PUBLICAÇÃO
2018-08
RESUMO
Abstract: Cutaneous melanoma is the solid neoplasia with the highest growing incidence among all tumors. It spreads predictably to the lymphatic vessels and sentinel lymph node, and when the latter is affected the prognosis worsens dramatically. Sentinel lymph node biopsy is considered when thickness of the primary tumor exceeds 1mm and/or when there are adverse features in thinner melanomas. When there is nodal metastasis, current evidence in the literature recommends complete lymphadenectomy, although this procedure has its intrinsic risks (i.e., lymphedema and cellulitis), and there are no published clinical trials proving additional overall survival benefits. The current in-depth literature review thus aims to identify patients that will benefit most from the procedure, including those with the highest likelihood of presenting additional affected lymph nodes in the same nodal basin. The authors also discuss techniques for identification of the sentinel lymph node, false-negative rates, and predictive models for lymph node involvement. In conclusion, complete elective lymphadenectomy should always be discussed on a case-by-case basis when metastases are detected in the sentinel lymph node.
Documentos Relacionados
- Sentinel lymph node biopsy in malignant melanoma
- Sentinel lymph node biopsy: Not yet standard of care for melanoma
- Sentinel lymph node biopsy: Sentinel node technique has drawbacks
- Therapeutic Effect of Sentinel Lymph Node Biopsy in Melanoma Remains an Open Question
- Sentinel lymph node biopsy: Authors' reply