España Manuel I, Signorini Franco, Marani Marcos, Alcaraz Alvaro, Reimondez Santiago, Romero Ma Eugenia, Obeide Lucio
Hospital Privado Universitario de Córdoba, Córdoba, Argentina.
Cir Cir. 2019;87(2):241-246. doi: 10.24875/CIRU.18000439.
The study of the Sentinel Lymph Node (SLN) in Melanoma is a procedure that aims the identification of the first node to which the affected cutaneous sector drains in order to avoid unnecessary lymphadenectomies. The present study documents the frequency of identification of SLN; the relationship between positive SLN (PSLN) and recurrence, between the Breslow index (BI) and PSLN, and between BI and disease recurrence.
We analyzed the records of 148 patients with melanoma stages I and II undergoing lymphatic mapping and GC biopsy from 1999 to 2017 in a third level institution in Córdoba, Argentina. We performed preoperative lympho centellography, lymphatic mapping with combined technique and SLN biopsy. Postoperative controls were established in order to detect recurrences.
SLN was identified in 145 patients (97.9%), being positive in 25 cases (17.2%). Recurrence was detected in 10 (8.3%) patients with negative SLN (NSLN), and in 2 (9.09%) with PSLN (p = 0.188). The median BI was 2 mm in PCG patients and 1.2 mm in GCN patients (p = 0.002). The mean BI in patients with recurrence was 2.77 mm, and 2.01 mm in those who did not show relapse (p = 0.311).
The combined technique allows a high GC identification rate. A greater tendency to recurrence was observed in the presence of CPG. A statistically significant relationship between GCP and IB was found. The GC technique is effective and replicable in our environment.
黑色素瘤前哨淋巴结(SLN)的研究是一种旨在识别受影响皮肤区域引流的首个淋巴结的程序,以避免不必要的淋巴结切除术。本研究记录了SLN的识别频率;阳性前哨淋巴结(PSLN)与复发之间的关系、Breslow指数(BI)与PSLN之间的关系以及BI与疾病复发之间的关系。
我们分析了1999年至2017年在阿根廷科尔多瓦一家三级医疗机构接受淋巴绘图和前哨淋巴结活检的148例I期和II期黑色素瘤患者的记录。我们进行了术前淋巴闪烁造影、联合技术淋巴绘图和前哨淋巴结活检。建立术后对照以检测复发情况。
145例患者(97.9%)识别出了前哨淋巴结,其中25例(17.2%)为阳性。10例(8.3%)前哨淋巴结阴性(NSLN)患者和2例(9.09%)PSLN患者检测到复发(p = 0.188)。PCG患者的BI中位数为2 mm,GCN患者为1.2 mm(p = 0.002)。复发患者的平均BI为2.77 mm,未复发患者为2.01 mm(p = 0.311)。
联合技术可实现较高的前哨淋巴结识别率。CPG存在时观察到更高的复发倾向。发现GCP与IB之间存在统计学显著关系。前哨淋巴结技术在我们的环境中是有效且可重复的。