皮肤黑色素瘤前哨淋巴结活检的特点及老年患者的特殊性——单中心经验

The Characteristics of Sentinel Lymph Node Biopsy in Cutaneous Melanoma and the Particularities for Elderly Patients-Experience of a Single Clinic.

作者信息

Bobircă Florin, Tebeică Tiberiu, Pumnea Adela, Dumitrescu Dan, Alexandru Cristina, Banciu Laura, Popa Ionela Loredana, Bobircă Anca, Leventer Mihaela, Pătrașcu Traian

机构信息

Surgery Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Surgery Department, Dr. Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania.

出版信息

Diagnostics (Basel). 2023 Mar 1;13(5):926. doi: 10.3390/diagnostics13050926.

DOI:10.3390/diagnostics13050926

PMID:36900069

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10001011/

Abstract

BACKGROUND

Melanoma is a malignant tumor that determines approximately 80% of deaths as skin cancer-related. The sentinel lymph node (SLN) represents the first filter of tumor cells toward systemic dissemination. The primary objective was to outline the surgical specifics of the sentinel lymph node biopsy (SLNB) technique, correlate the location of the lymph node with the radiotracer load, and identify the characteristics of older patients.

METHODS

In this prospective study, 122 cases of malignant melanoma needing SLNB technique were included, between June 2019 and November 2022, resulting in 162 lymph nodes removed.

RESULTS

Patients' mean age was 54.3 ± 14.4 years old, the prevalence of 70 years and older being 20.5%. The rate of positive SLN was 24.6%, with a single drainage in 68.9% of cases. The frequency of seroma was 14.8%, while reintervention 1.6%. The inguinal nodes had the highest preoperative radiotracer load ( = 0.015). Patients 70 years old or older had significantly more advanced-stage melanoma (68.0% vs. 45.4%, = 0.044, OR = 2.56) and a higher rate of positive SLN (40.0% vs. 20.6%, = 0.045,OR = 2.57). Melanoma of the head and neck was more common among older individuals (32.0% vs. 9.3%, = 0.007,OR = 4.60).

CONCLUSIONS

The SLNB has a low rate of surgical complications and the positivity of SLN is not related to radiotracer load. Elderly patients are at risk for head and neck melanoma, have more advanced stages, a higher SLN positivity, and a greater rate of surgical complications.

摘要

背景

黑色素瘤是一种恶性肿瘤，约80%的皮肤癌相关死亡由其导致。前哨淋巴结（SLN）是肿瘤细胞向全身扩散的第一道屏障。主要目的是概述前哨淋巴结活检（SLNB）技术的手术细节，将淋巴结位置与放射性示踪剂负荷相关联，并确定老年患者的特征。

方法

在这项前瞻性研究中，纳入了2019年6月至2022年11月期间122例需要SLNB技术的恶性黑色素瘤病例，共切除162个淋巴结。

结果

患者的平均年龄为54.3±14.4岁，70岁及以上患者的患病率为20.5%。SLN阳性率为24.6%，68.9%的病例为单一引流。血清肿发生率为14.8%，再次干预率为1.6%。腹股沟淋巴结术前放射性示踪剂负荷最高（=0.015）。70岁及以上患者的黑色素瘤分期明显更晚（68.0%对45.4%，=0.044，OR=2.56），SLN阳性率更高（40.0%对20.6%，=0.045，OR=2.57）。头颈部黑色素瘤在老年个体中更常见（32.0%对9.3%，=0.007，OR=4.60）。