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Annals of Surgical Oncology 10:196-200 (2003)
© 2003 Society of Surgical Oncology

ORIGINAL ARTICLES

Delayed Harvesting of Sentinel Lymph Nodes After Previous Wide Local Excision of Extremity Melanoma

Stanley P. L. Leong, MD, Marylou C. Thelmo, MD, Robert P. Kim, MD, Rahul Gokhale, MD, Jennifer Y. Rhee, BA, Theodore A. Achtem, BS, Eugene Morita, MD, Robert E. Allen, Jr, MD, Mohammed Kashani-Sabet, MD and Richard W. Sagebiel, MD

From the Departments of Surgery (SPLL, MCT, RPK, RG, JYR, TAA, REA), Nuclear Medicine (EM), and Dermatology (MK-S, RWS), Melanoma Center, University of California, San Francisco Medical Center at Mount Zion and University of California, San Francisco Comprehensive Cancer Center, San Francisco, California.

Correspondence: Address correspondence and reprint requests to: Stanley P. L. Leong, MD, Department of Surgery, Box 1674, UCSF Medical Center at Mt. Zion/UCSF Comprehensive Cancer Center, 1600 Divisadero Street, #C333, San Francisco, CA 94143-1674; Fax: 415-353-7721; E-mail: leongs{at}surgery.ucsf.edu

Background: Harvesting the sentinel lymph node (SLN) is important in the management of patients with primary cutaneous melanoma. Selective sentinel lymphadenectomy (SSL) is generally performed at the time of wide local excision (WLE). The aim of our study was to determine whether delayed SSL is useful in detecting micrometastasis to the regional basin in patients with previous WLE of an extremity melanoma.

Methods: Of 203 patients with a primary melanoma site located on the upper or lower extremity seen at the University of California, San Francisco/Mount Zion Melanoma Center from May 17, 1994, to March 23, 1999, 24 patients had a WLE of their extremity melanoma with adequate margins before referral. SSL was performed to assess micrometastasis in the regional lymph node basin after preoperative lymphoscintigraphy.

Results: At least 1 SLN was identified in all 24 patients. At a median follow-up of 3 years, two patients showed micrometastasis in the SLNs. One of these two patients developed recurrence, and all remaining patients showed no evidence of disease.

Conclusions: Although it is generally advised that WLE should be performed simultaneously with SSL, delayed SSL after WLE of an extremity melanoma can still provide valuable staging information, which is critical for management of the patient.

Key Words: Extremity • Melanoma • Previous wide excision • Sentinel lymph node




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V. H. Stell, H. J. Norton, K. S. Smith, J. C. Salo, and R. L. White Jr.
Method of Biopsy and Incidence of Positive Margins in Primary Melanoma
Ann. Surg. Oncol., February 1, 2007; 14(2): 893 - 898.
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