Gomez-Rivera Fernando, Santillan Alfredo, McMurphey Andrea Barber, Paraskevopoulos George, Roberts Dianna B, Prieto Victor G, Myers Jeffrey N
Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Head Neck. 2008 Oct;30(10):1284-94. doi: 10.1002/hed.20875.
Controversy remains regarding the benefits of sentinel lymph node (SLN) biopsy for predicting survival in cutaneous melanoma of the head and neck (CMHN).
We analyzed the factors associated with the recurrence and survival of CMHN patients treated in our institution.
One hundred thirteen patients underwent SLN biopsy for CMHN in a 12-year period. SLN identification was successful in 96%, with a median of 3 SLNs per patient. Positive-SLNs were identified in 21%. With a median follow-up of 34 months, 28% recurred. Disease-free survival (DFS) and overall survival (OS) rates were 66% and 78% in patients with SLN-negative, and 39% and 62% in SLN-positive disease. In multivariate analysis, greater Breslow-thickness was associated with decreased DFS rate (HR 2.07, CI 1.04-4.09), and age>60 years (HR 3.53, CI 1.32-9.4) with lower 5-year OS rate.
Primary tumor thickness and age were associated with decreased survival, whereas SLN status showed a trend for prognostic significance in CMHN.
前哨淋巴结（SLN）活检对预测头颈部皮肤黑色素瘤（CMHN）患者生存率的益处仍存在争议。
我们分析了在我院接受治疗的CMHN患者复发和生存的相关因素。
在12年期间，113例患者因CMHN接受了SLN活检。SLN识别成功率为96%，每位患者的SLN中位数为3个。21%的患者SLN为阳性。中位随访34个月，28%的患者复发。SLN阴性患者的无病生存率（DFS）和总生存率（OS）分别为66%和78%，SLN阳性患者分别为39%和62%。多因素分析显示，更大的Breslow厚度与DFS率降低相关（HR 2.07，CI 1.04 - 4.09），年龄>60岁与5年OS率降低相关（HR 3.53，CI 1.32 - 9.4）。
原发肿瘤厚度和年龄与生存率降低相关，而SLN状态在CMHN中显示出预后意义的趋势。
