Articles

OPTIMIZING THE STAGING OF MELANOMA PATIENTS FOR THEIR BEST SURGICAL MANAGEMENT

Authors
  • G Giudice
  • E Nacchiero
  • F Robusto
  • C.C. Campisi
  • C Campisi

Abstract

Interval nodes (IN) are defined as lymph nodes that lie along the course of lymphatic collecting vessels between a primary tumor site and a draining node field. Sometimes INs contain metastases and a consensus on their surgical management is needed. Therefore, to optimize the surgical management of melanoma patients with metastatic lymphatic involvement, especially when the sentinel lymph node biopsy identifies an unusual drainage field, we identified patients treated at the Department of Plastic and Reconstruction Surgery of Bari between July 1994 and December 2012 identified with a primary cutaneous melanoma who underwent lymphoscintigraphy and subsequent positive-IN the lymphadenectomy to evaluate the impact of this procedure on overall survival and disease-free-period. 51 patients presented INs, and lymphadenectomy (LA) of the subsequent lymphatic field was performed in 13 subjects with positive-IN. In 4 cases additional lymphatic metastases were detected in the usual basin beyond the IN+. Recurrence-free period and survival rate at 5 years were higher in patients with positive-IN who underwent LA than in subjects who underwent LA due to positive lymph nodes in the usual field. Immediate lymphadenectomy of the subsequent lymphatic field in patients with positive-INs may afford patients earlier stage treatment of their disease and improved prognosis.

Keywords: melanoma, interval node, lymphatic mapping, sentinel node biopsy, in-transit lymph node, lymphoscintigraphy, prognosis

How to Cite:

Giudice, G. & Nacchiero, E. & Robusto, F. & Campisi, C. & Campisi, C., (2015) “OPTIMIZING THE STAGING OF MELANOMA PATIENTS FOR THEIR BEST SURGICAL MANAGEMENT”, Lymphology 48(4), 163-174.

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Published on
16 Mar 2015
Peer Reviewed