Micrometastasis to In-Transit Lymph Nodes From Extremity and Truncal Malignant Melanoma |
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Authors: | Marylou C. Thelmo MD MPH Eugene T. Morita MD Patrick A. Treseler MD PhD Luyen Huu Nguyen BA Robert E. Allen Jr. MD Richard W. Sagebiel MD Mohammed Kashani-Sabet MD Stanley P. L. Leong MD |
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Affiliation: | (1) Department of Surgery, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, San Francisco, California;(2) Department of Nuclear Medicine, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, San Francisco, California;(3) Department of Pathology, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, San Francisco, California;(4) Department of Melanoma Center, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, San Francisco, California;(5) Department of Surgery, UCSF Comprehensive Cancer Center, 1600 Divisadero Street, Suite C333, San Francisco, CA, 94115 |
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Abstract: | Background: The sentinel lymph node (SLN) is the first lymph node in the regional nodal basin to receive metastatic cells. In-transit nodes are found between the primary melanoma site and regional nodal basins. To date, this is one of the first reports on micrometastasis to in-transit nodes.Methods: Retrospective database and medical records were reviewed from October 21, 1993, to November 19, 1999. At the UCSF Melanoma Center, patients with tumor thickness >1 mm or <1 mm with high-risk features are managed with preoperative lymphoscintigraphy, selective SLN dissection, and wide local excision.Results: Thirty (5%) out of 557 extremity and truncal melanoma patients had in-transit SLNs. Three patients had positive in-transit SLNs and negative SLNs in the regional nodal basin. Two patients had positive in-transit and regional SLNs. Three patients had negative in-transit SLNs but positive regional SLNs. The remaining 22 patients were negative for in-transit and regional SLNs.Conclusions: In-transit SLNs may harbor micrometastasis. About 10% of the time, micrometastasis may involve the in-transit and not the regional SLN. Therefore, both in-transit and regional SLNs should be harvested.Supported in part by a grant from the Eva B. Buck Charitable Trust. |
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Keywords: | Melanoma Micrometastasis In-transit sentinel lymph node |
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