新西兰一家乡村医院开展黑色素瘤前哨淋巴结活检的十二年经验。

Twelve years' experience of sentinel lymph node biopsy for melanoma at a rural New Zealand hospital.

作者信息

Sakowska Magdalena M, Smith Nicole, Coutts Richard J

机构信息

Department of General and Vascular Surgery, Palmerston North Hospital, Mid-Central District Health Board, PO Box 2056, Palmerston North 4440, New Zealand.

出版信息

N Z Med J. 2014 Jun 6;127(1395):12-22.

PMID:24929689

Abstract

AIM

To document the false-negative sentinel lymph node biopsy (SLNB) rate for melanoma patients at a rural NZ hospital and the likelihood of further nodal involvement on completion lymph node dissection (CLND).

METHODS

All patients undergoing SLNB for melanoma at this centre were identified from the study period. Basic demographics along with histological data of both the primary lesion and SLNB were collated. Local and regional recurrences were recorded as was mortality.

RESULTS

Between January 2000 and July 2012, 95 patients underwent SLNB for melanoma. Ten patients (11%) underwent CLND after positive SLNB. A further two patients had a median of two additional nodes involved (range 1-3). After a median follow-up period of 65 months (range 47-112), 6 patients suffered nodal recurrence where previously a negative SLNB had been harvested, giving a false-negative rate of 38%. Recurrence occurred a median of 16 months after WLE and SLNB.

CONCLUSION

A high false negative-negative rate was observed in this study. For those with a positive SLNB, a further 20% have further nodal involvement on CLND.

摘要

目的

记录新西兰一家乡村医院黑色素瘤患者前哨淋巴结活检（SLNB）的假阴性率，以及完成淋巴结清扫术（CLND）后出现进一步淋巴结受累的可能性。

方法

从研究期间确定在该中心接受黑色素瘤SLNB的所有患者。整理基本人口统计学资料以及原发灶和SLNB的组织学数据。记录局部和区域复发情况以及死亡率。

结果

2000年1月至2012年7月期间，95例患者接受了黑色素瘤SLNB。10例患者（11%）在SLNB呈阳性后接受了CLND。另有2例患者平均有另外两个淋巴结受累（范围1 - 3个）。中位随访期65个月（范围47 - 112个月）后，6例患者出现淋巴结复发，此前SLNB结果为阴性，假阴性率为38%。复发发生在广泛局部切除（WLE）和SLNB后中位16个月。