Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
Head Neck. 2011 Jan;33(1):7-12. doi: 10.1002/hed.21403.
Although existing melanoma literature provides recommendations for thinner lesions (≤1 mm) within a heterogeneous population, a focus on the head and neck group is less pervasive.
The records of 49 node-negative individuals with thin head and neck melanoma that underwent surgical intervention ± sentinel lymph node (SLN) biopsy were reviewed.
A significant increased Breslow thickness and mitotic rate, and a trend toward significance in Clark level ≥ IV were shown in patients that underwent an SLN biopsy versus those that did not. The total number of positive biopsies was 2 (5%). In our subset analysis using the modified American Joint Committee on Cancer recommendations by Wong and colleagues, the incidence of positive SLN biopsy would have increased to 11%.
We advocate performing an SLN biopsy in thin head and neck melanomas for primary tumors > 0.75 mm, regardless of "high-risk" features as described by Wong and colleagues.
尽管现有的黑色素瘤文献为异质人群中≤1 毫米的较薄病变提供了建议，但对头部和颈部人群的关注却较少。
回顾了 49 例接受手术干预±前哨淋巴结（SLN）活检的无淋巴结转移、薄型头颈部黑色素瘤的个体记录。
与未行 SLN 活检的患者相比，行 SLN 活检的患者的 Breslow 厚度和有丝分裂率显著增加，Clark 分级≥IV 也有显著趋势。阳性活检的总数为 2（5%）。在我们使用 Wong 等人的改良美国联合委员会癌症建议进行的亚组分析中，阳性 SLN 活检的发生率将增加到 11%。
我们主张对>0.75mm 的原发性头颈部薄型黑色素瘤进行 SLN 活检，无论 Wong 等人描述的是否具有“高危”特征。
