Clinical importance and surgical management of sentinel lymph nodes in the popliteal fossa of melanoma patients |
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| Affiliation: | 1. Melanoma Institute Australia, The University of Sydney, Sydney, Australia;2. University of Utrecht, Utrecht, the Netherlands;3. Skin Cancer Department, A.C. Camargo Cancer Center, São Paulo, Brazil;4. Alfred Nuclear Medicine and Ultrasound, Sydney, Australia;5. Faculty of Medicine and Health, The University of Sydney, Sydney, Australia;6. Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, Australia;1. Surgical Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, Italy;2. Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Italy;3. Department of Medicine (DIMED), University of Padova, Italy;4. Independent Statistician, Solagna, Italy;1. Colorectal Surgery - Champalimaud Foundation, Lisbon, Portugal;2. Radiation Oncology - Champalimaud Foundation, Lisbon, Portugal;3. Radiology - Champalimaud Foundation, Lisbon, Portugal;4. Pathology - Champalimaud Foundation, Lisbon, Portugal;5. Medical Oncology - Champalimaud Foundation, Lisbon, Portugal;6. Surgical Oncology - The Netherlands Cancer Institute, Amsterdam, the Netherlands;1. Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK;2. Liverpool Clinical and Cancer Research UK Trials Unit, University of Liverpool, Liverpool, UK;3. Department of Hepato-Biliary Medicine, University Hospital Aintree, Liverpool, UK;4. Department of Hepato-Biliary Medicine, Royal Liverpool Hospital, Liverpool, UK;5. Department of Radiology, University Hospital Aintree, Liverpool, UK;6. Department of Radiology, Royal Liverpool Hospital, Liverpool, UK;7. Oncology Department, Clatterbridge Hospital, Bebington, UK;1. Department of Gynecological Oncology Surgery, Centre de Lutte Contre le Cancer Oscar Lambret, 3 Rue Combemale, 59020, Lille Cedex, France;2. Department of Statistics, Centre de Lutte Contre le Cancer Oscar Lambret, 3 Rue Combemale, 59020, Lille Cedex, France |
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| Abstract: | Background and purposePatients with a primary melanoma below the knee may have lymphatic drainage to a sentinel node (SN) in the popliteal fossa. The purpose of this study was to analyze lymphatic drainage to this site and to describe clinical features and surgical management of SNs in the popliteal fossa.MethodsPatients with a primary melanoma below the knee presenting to Melanoma Institute Australia between 1992 and 2013 were analyzed. Those found to have a popliteal SN were evaluated. Data on imaging, SN biopsy, completion lymph node dissection, morbidity and follow-up were analyzed.ResultsLymphoscintigraphy showed drainage to a popliteal SN in 176 of 3902 cases of melanoma below the knee (4.5%). In 96 of these patients (55%) a popliteal SN biopsy was attempted. The procedure failed to identify the node(s) in seventeen of them (18%). Thirteen of the 79 patients (17%) had a positive popliteal SN and in eight (10%) this was the only positive node. The tumor stage of ten patients (13%) changed as a result of the popliteal node biopsy. A positive popliteal node was associated with an increased risk of recurrence and diminished overall survival. Popliteal SN biopsy did not improve regional control or survival.ConclusionMelanomas below the knee infrequently drain to lymph nodes in the popliteal fossa. Although popliteal SN biopsy can be challenging, it is worthwhile, providing improved staging and guiding subsequent management. |
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| Keywords: | Melanoma Sentinel node biopsy Popliteal fossa Sentinel node" },{" #name" :" keyword" ," $" :{" id" :" kwrd0030" }," $$" :[{" #name" :" text" ," _" :" SN |
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