Lymphatic Drainage Patterns from Melanomas on the Shoulder or Upper Trunk to Cervical Lymph Nodes and Implications for the Extent of Neck DissectionReport as inadecuate




Lymphatic Drainage Patterns from Melanomas on the Shoulder or Upper Trunk to Cervical Lymph Nodes and Implications for the Extent of Neck Dissection - Download this document for free, or read online. Document in PDF available to download.

Annals of Surgical Oncology

, Volume 19, Issue 12, pp 3906–3912

First Online: 11 May 2012Received: 21 August 2011

Abstract

PurposeTo determine the incidence and pattern of cervical lymphatic drainage in patients with melanomas located on the upper limb or trunk, and to evaluate our current neck dissection protocol for those patients with a N+ neck.

MethodsOf 1192 melanoma patients who underwent sentinel node biopsy, 631 were selected with a primary tumor on the upper limb or trunk. All lymphoscintigrams, SPECT-CT images and operative reports were reviewed to determine the exact locations of sentinel nodes visualized preoperatively and dissected during operation.

ResultsThirty-nine 6.2 % of 631 patients with a melanoma on the upper limb or trunk showing cervical lymph node drainage were identified. In 34 87 % of 39 patients, sentinel nodes were excised from level IV or Vb, and in 30 of those 39 patients simultaneous from the axilla. In the remaining five patients 13 %, sentinel nodes were collected from level IIb, level III or the suboccipital region. All collected sentinel nodes were located in the intended dissection area for N+ patients. Thirteen patients 33 % had a total of 22 tumor-positive sentinel nodes in either the axilla n = 10, level IV n = 2, Vb n = 9 or suboccipital n = 1.

ConclusionsOnly a minority of the patients with upper limb or trunk melanomas demonstrated lymphatic drainage to cervical lymph node basins, with preferential drainage to levels IV and Vb. Our current dissection protocol of levels II–V, with or without extension to the suboccipital region, in those patients with involved cervical sentinel nodes seems sufficient.

Download fulltext PDF



Author: Hidde J. Veenstra - W. Martin C. Klop - Maarten J. Speijers - Peter J. F. M. Lohuis - Omgo E. Nieweg - Harald J. Ho

Source: https://link.springer.com/article/10.1245/s10434-012-2387-2







Related documents