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RF-Sentinel Lymph Node Biopsy in Head and Neck Melanoma
FR-Biopsia Selectiva de Ganglio Centinela en Melanoma de Cabeza y Cuello
T. Montero-Vilchez
, A. Martinez-Lopez, L. Salvador-Rodriguez, S. Arias-Santiago
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Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Montero-Vilchez, A. Martinez-Lopez, L. Salvador-Rodriguez, S. Arias-Santiago" "autores" => array:4 [ 0 => array:4 [ "nombre" => "T." "apellidos" => "Montero-Vilchez" "email" => array:2 [ 0 => "tmonterov@gmail.com" 1 => "dramonterovilchez@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Martinez-Lopez" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Salvador-Rodriguez" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "Arias-Santiago" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR-Biopsia Selectiva de Ganglio Centinela en Melanoma de Cabeza y Cuello" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Lymph node invasion is a factor for poor prognosis in melanoma and selective sentinel lymph node biopsy (SLNB) is the technique of choice for lymph node staging. Since 2012, most clinical practice guidelines recommend SLNB in melanomas at least 1<span class="elsevierStyleHsp" style=""></span>mm thick (in reality, in melanomas with a Breslow depth greater than 0.8<span class="elsevierStyleHsp" style=""></span>mm or with unfavorable prognostic factors such as ulceration) for patients with no clinical evidence of lymph node enlargement and without contraindications for the procedure. Although such biopsies have not been shown to specifically prolong survival, they enable early and more precise staging of patients, making many of them candidates for adjuvant treatment and so able to benefit from greater secondary survival. However, at times, adherence to the guidelines is limited, as shown in a recent study reporting that the recommendations concerning SLNB are followed in 39.7% of patients with melanoma.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Site, sex, sage, race, and even socioeconomic factors seem to influence whether the procedure is performed.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Specifically, head and neck melanoma (HNM) is associated with low rates of SLNB. This may be attributed to several reasons:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1)</span><p id="par0015" class="elsevierStylePara elsevierViewall">The complexity and variability in lymph node drainage of the head and neck. Stewart and coworkers<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> analyzed 269 patients with HNM and found that 25% of them had lymph node drainage to multiple basins, without detecting any differences between patients with lymph node drainage to single or multiple basis. It is therefore hard to predict which patients would be the most appropriate candidates for SLNB.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2)</span><p id="par0020" class="elsevierStylePara elsevierViewall">Difficulties with the technique and mapping of lymph nodes of the head and neck. Small lymph nodes and vessels and the location at a greater depth than other sites, as well as the need to preserve adjacent structures, make the technique more complicated than is the case for lymph nodes in the axilla or groin. Accidental damage to the sensory nerves, temporary paresis of the facial nerve after dissection of the parotid gland, and lesion of the accessory spinal nerve with persistent weakness can all occur.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3)</span><p id="par0025" class="elsevierStylePara elsevierViewall">Greater rate of false negatives and recurrence in comparison with other sites. Data from 2610 patients included in the Sunbelt Melanoma Trial showed that the rate of false negatives in HNM was significantly greater than for melanoma located on the trunk and limbs (12%, 2%, and 3%, respectively). In an attempt to address this issue, a new technique has recently been described using indocyanine green as a sentinel lymph node marker in conjunction with the SPY Elite infrared imaging system. With this technique, a lower rate of false negatives was observed compared with the conventional technique.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p></li></ul></p><p id="par0030" class="elsevierStylePara elsevierViewall">Recent studies on the use of SLNB and HNM analyzed survival among patients with positive and negative SLNB, and found differences between the 2 groups. Furthermore, Pavri and coworkers,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> in a retrospective study, observed that 92% of melanomas with negative lymphoscintigraphy prior to SLNB were HNM. Likewise, those patients with negative preoperative lymphoscintigraphy had a shorter disease-free survival compared with those with visible lymph nodes. These results highlight the need to perform a more exhaustive locoregional ultrasound in patients with HNM, particularly in those with negative lymphoscintigraphy.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In conclusion, there is a certain disagreement in the indications for SLNB in HNM. Randomized clinical trials would be necessary to determine whether this technique can improve survival in these patients.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they did not receive any external funding for this study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "xpalclavsec1310294" "titulo" => "Palabras clave" ] 1 => array:2 [ "identificador" => "xpalclavsec1310293" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1310293" "palabras" => array:2 [ 0 => "Head and neck melanoma" 1 => "Sentinel lymph node biopsy" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Montero-Vilchez T, Martinez-Lopez A, Salvador-Rodriguez L, Arias-Santiago S. FR-Biopsia selectiva de ganglio centinela en melanoma de cabeza y cuello. Actas Dermosifiliogr. 2020;111:870–871.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trends in sentinel lymph node biopsy enactment for cutaneous melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.A. El Sharouni" 1 => "A.J. Witkamp" 2 => "V. Sigurdsson" 3 => "P.J. van Diest" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/s10434-019-07204-2" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2019" "volumen" => "26" "paginaInicial" => "1494" "paginaFinal" => "1502" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30719636" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implications of sentinel lymph node drainage to multiple basins in head and neck melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.L. Stewart" 1 => "A. Gleisner" 2 => "J. Kwak" 3 => "B. Chapman" 4 => "N. Pearlman" 5 => "C. Gajdos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/s10434-016-5744-8" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2017" "volumen" => "24" "paginaInicial" => "1386" "paginaFinal" => "1391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28058553" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dilemma of clinically node-negative head and neck melanoma: outcome of “watch and wait” policy, elective lymph node dissection, and sentinel node biopsy - a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.T. Pieter" 1 => "E.O. Nieweg" 2 => "M.W.M. van den Brekel" 3 => "A.J.M. Balm" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Head Neck" "fecha" => "2014" "volumen" => "36" "paginaInicial" => "1391" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sentinel lymph node biopsy in cutaneous melanoma of the head and neck using the indocyanine green SPY Elite system" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.M. Vahabzadeh-Hagh" 1 => "K.E. Blackwell" 2 => "E. Abemayor" 3 => "M.A.St John" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjoto.2018.05.006" "Revista" => array:6 [ "tituloSerie" => "Am J Otolaryngol" "fecha" => "2018" "volumen" => "39" "paginaInicial" => "485" "paginaFinal" => "488" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29803536" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonvisualization of sentinel lymph nodes by lymphoscintigraphy in primary cutaneous melanoma: incidence, risk factors, and a review of management options" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.N. Pavri" 1 => "C. Gary" 2 => "R.S. Martinez" 3 => "S. Kim" 4 => "D. Han" 5 => "S. Ariyan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PRS.0000000000004771" "Revista" => array:6 [ "tituloSerie" => "Plast Reconstr Surg" "fecha" => "2018" "volumen" => "142" "paginaInicial" => "527e" "paginaFinal" => "534e" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30020233" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011100000010/v1_202012160744/S1578219020303085/v1_202012160744/en/main.assets" "Apartado" => array:4 [ "identificador" => "34945" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Resident's Forum" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011100000010/v1_202012160744/S1578219020303085/v1_202012160744/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020303085?idApp=UINPBA000044" ]
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