Sentinel Lymph Node Biopsy, Lymph Node Dissection, and Lymphedema Management Options in Melanoma - 07/09/21

Doi : 10.1016/j.cps.2021.05.005

Brian A. Mailey, MD ^a,^⁎ , Ghaith Alrahawan, MS ^b, Amanda Brown, BS ^c, Maki Yamamoto, MD ^d, Aladdin H. Hassanein, MD, MMSc ^e
^a Brachial Plexus and Tetraplegia Clinic, Institute for Plastic Surgery, Southern Illinois University School of Medicine, 747 N. Rutledge Street, PO Box 19653, Springfield, IL 62794, USA
^b University of Missouri Columbia, School of Medicine, 1 Hospital Dr, Columbia, MO 65212, USA
^c Southern Illinois University, School of Medicine, 747 N. Rutledge Street, PO Box 19653, Springfield, IL 62794, USA
^d Division of Surgical Oncology, Department of Surgery, University of California, Irvine, 333 City Blvd West, Suite 1600, Orange, CA 92868, USA
^e Division of Plastic Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Suite 232, Indianapolis, IN 46202, USA

^∗Corresponding author.

Résumé

Melanoma tumor thickness and ulceration are the strongest predictors of nodal spread. The recommendations for sentinel lymph node biopsy (SLNB) have been updated in recent American Joint Committee on Cancer and National Comprehensive Cancer Network guidelines to include tumor thickness ≥0.8 mm or any ulcerated melanoma. Mitotic rate is no longer considered an indicator for determining T category. Improvements in disease-specific survival conferred from SLNB were demonstrated through level I data in the Multicenter Selective Lymphadenectomy Trial (MSLT) I. The role for completion lymph node dissection has evolved to less surgery in lieu of recent domestic (MSLT II) and international (Dermatologic Cooperative Oncology Group Selective Lymphadenectomy Trial [DeCOG-SLT]) level I data having similar melanoma-specific survival. Treatment options for the prevention of treatment of lymphedema have progressed to include immediate lymphatic reconstruction, lymphovenous anastomosis, and vascularized lymph node transfer.

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Keywords : Melanoma, Sentinel lymph node biopsy, Lymph node dissection, Lymphedema

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Completion lymph node dissection

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Vol 48 - N° 4

P. 607-616 - octobre 2021 Retour au numéro

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Sentinel Lymph Node Biopsy, Lymph Node Dissection, and Lymphedema Management Options in Melanoma - 07/09/21

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