Annals of Surgical Oncology, Vol 4, Issue 3 247-251, Copyright © 1997 by Society of Surgical Oncology

ARTICLES

Lymphoscintigraphy as a predictor of lymphatic drainage from cutaneous melanoma

D. H. Berger, B. W. Feig, D. Podoloff, J. Norman, C. W. Cruse, D. S. Reintgen and M. I. Ross
Department of Surgery, University of Texas M.D. Anderson Cancer Center, Houston, USA.

BACKGROUND: If cutaneous lymphoscintigraphy (CL) is accurate in predicting the draining lymph node basins at risk from primary axial melanomas, then regional metastases should only occur in those lymph node basins identified by CL. METHODS: This study is a retrospective review of patients undergoing CL for primary axial melanomas from June 1, 1985, until June 31, 1992. Data retrieved included age, gender, number of basins identified, location of basins identified, management of basins, recurrence in lymphatics, development of distant disease, and long-term follow-up. RESULTS: A total of 181 patients underwent elective LND, and 48 patients (27%) had melanoma in the nodes within the dissected basin. Of these 181 patients, seven developed nodal metastases as their site of first recurrence. All seven recurrences were seen at sites dissected or at sites indicated by CL, which the primary surgeon elected not to treat initially. Of the 116 patients observed, 16 (14%) developed lymph node metastases as their first site of recurrence. Fifteen of these 16 patients had their site of lymph node metastases predicted by CL. In this study, CL predicted 98.6% of all lymph node metastases. CONCLUSIONS: The high overall reliability of CL as demonstrated by long-term follow-up indicates that the information obtained by CL can be reliably used to guide intervention. Initial evaluation of patients with high-risk cutaneous melanomas at sites with ambiguous lymphatic drainage must include CL in order to determine the draining lymph node basins and to plan therapy.

This article has been cited by other articles:

				G. Mariani, M. Gipponi, L. Moresco, G. Villa, M. Bartolomei, G. Mazzarol, M. C. Bagnara, A. Romanini, F. Cafiero, G. Paganelli, et al. Radioguided Sentinel Lymph Node Biopsy in Malignant Cutaneous Melanoma* J. Nucl. Med., June 1, 2002; 43(6): 811 - 827. [Abstract] [Full Text] [PDF]

				M. C. Thelmo, E. T. Morita, P. A. Treseler, L. H. Nguyen, R. E. Allen Jr., R. W. Sagebiel, M. Kashani-Sabet, and S. P. L. Leong Micrometastasis to In-Transit Lymph Nodes From Extremity and Truncal Malignant Melanoma Ann. Surg. Oncol., June 1, 2001; 8(5): 444 - 448. [Abstract] [Full Text] [PDF]

				R. A. Valdés Olmos and O. E. Nieweg Reproducibility of Cutaneous Lymphoscintigraphy: Same or Different Lymphatic Routes and Sentinel Nodes After Reinjection? J. Nucl. Med., March 1, 2001; 42(3): 430 - 431. [Full Text]

				S. P. L. Leong, T. A. Achtem, F. A. Habib, I. Steinmetz, E. Morita, R. E. Allen, M. Kashani-Sabet, and R. Sagebiel Discordancy Between Clinical Predictions vs Lymphoscintigraphic and Intraoperative Mapping of Sentinel Lymph Node Drainage of Primary Melanoma Arch Dermatol, December 1, 1999; 135(12): 1472 - 1476. [Abstract] [Full Text] [PDF]

				J. F. Eary, D. A. Mankoff, L. K. Dunnwald, D. R. Byrd, B. O. Anderson, R. S. Yeung, and R. E. Moe Sentinel Lymph Node Mapping for Breast Cancer: Analysis in a Diverse Patient Group Radiology, October 1, 1999; 213(2): 526 - 529. [Abstract] [Full Text]