前哨淋巴结引流作为皮肤黑色素瘤患者的预后因素
In transit sentinel node drainage as a prognostic factor for patients with cutaneous melanoma.
作者信息
Brandão Paulo H D M, Bertolli Eduardo, Doria-Filho Eduardo, Santos Filho Ivan D A O, de Macedo Mariana P, Pinto Clovis A L, Duprat Neto João P
机构信息
Surgical Oncology Medical Residence Program, AC Camargo Cancer Center, São Paulo, Brazil.
Skin Cancer Department, AC Camargo Cancer Center, São Paulo, Brazil.
出版信息
J Surg Oncol. 2018 Apr;117(5):864-867. doi: 10.1002/jso.25023. Epub 2018 Feb 26.
BACKGROUND
Minor basin or in transit node drainage can be found in patients with cutaneous melanoma who undergo sentinel node biopsy. Its clinical impact is still unclear. Our objective is to evaluate clinical outcomes in patients who presented with in transit sentinel node (ITN) drainage.
MATERIAL AND METHODS
Retrospective analysis of patients who underwent sentinel node biopsy (SNB) in a single Brazilian institution between 2000 and 2015.
RESULTS
Our cohort comprised 1223 SNB. There were 64 patients (5.2%) with ITN. Melanoma of the limbs (OR 10.61, P < 0.0001) and acral subtype (OR 3.49, P < 0.0001) were associated with ITN drainage. Among these 64 patients, 14 (21.9%) had a positive SNB. The ITN was positive for metastases in five patients, four in a popliteal basin and one on the trunk. Regarding completion node dissection (CND), two patients had positive non-sentinel nodes (NSN), both in major basins. In patients who developed recurrence, time to recurrence was shorter (mean time 18 vs 31.4 months, P = 0.001) and time to death was shorter (mean time 31.6 vs 40 months, P = 0.039) in those who had ITN drainage.
CONCLUSION
ITN drainage was associated with earlier recurrences and deaths from melanoma.
背景
在接受前哨淋巴结活检的皮肤黑色素瘤患者中可发现小流域或转移途中淋巴结引流。其临床影响尚不清楚。我们的目的是评估出现转移途中前哨淋巴结（ITN）引流的患者的临床结局。
材料与方法
对2000年至2015年在巴西一家机构接受前哨淋巴结活检（SNB）的患者进行回顾性分析。
结果
我们的队列包括1223例SNB。有64例患者（5.2%）出现ITN。肢体黑色素瘤（比值比10.61，P < 0.0001）和肢端亚型（比值比3.49，P < 0.0001）与ITN引流相关。在这64例患者中，14例（21.9%）前哨淋巴结活检结果为阳性。5例患者的ITN有转移，4例在腘窝流域，1例在躯干。关于完成淋巴结清扫（CND），2例患者的非前哨淋巴结（NSN）为阳性，均在主要流域。在出现复发的患者中，有ITN引流的患者复发时间较短（平均时间18个月对31.4个月，P = 0.001），死亡时间较短（平均时间31.6个月对40个月，P = 0.039）。
结论
ITN引流与黑色素瘤的早期复发和死亡相关。
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