Is pelvic sentinel node biopsy necessary for lower extremity and trunk melanomas?

Darryl Schuitevoerder, Stanley P.L. Leong, Jonathan S. Zager, Richard L. White, Eli Avisar, Heidi Kosiorek, Amylou Dueck, Jeanine Fortino, Mohammed Kashani-Sabet, Kyle Hart, John T. Vetto

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2 Scopus citations

Abstract

Objective: There is currently no consensus regarding how to address pelvic sentinel lymph nodes (PSLNs) in melanoma. Thus, our objectives were to identify the incidence and clinical impact of PSLNs. Methods: Retrospective review of a prospectively collected multi-institutional melanoma database. Results: Of 2476 cases of lower extremity and trunk melanomas, 227 (9%) drained to PSLNs (181 to both PSLNs and superficial (inguinal or femoral) sentinel lymph nodes (SSLN) and 46 to PSLNs alone). Seventeen (7.5%) of 227 PSLN cases were positive for nodal metastasis, 8 of which drained to PSLNs only while 9 drained to both PSLNs and SSLNs. Complication rates between PSLN and SSLN biopsy were similar (15% vs. 14% respectively). In 181 cases with drainage to both SSLNs and PSLNs, PSLN biopsy upstaged one patient (0.6%), and completion dissection based on a positive PSLN did not upstage any. Conclusions: PSLN biopsy is safe, however in the setting of negative SSLNs there is minimal clinical impact. We therefore recommend PSLN biopsy when the SSLNs are positive or when the tumor drains to PSLNs alone.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Dec 17 2016

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Keywords

  • Iliac/obturator node
  • Melanoma
  • Pelvic node
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Surgery

Cite this

Schuitevoerder, D., Leong, S. P. L., Zager, J. S., White, R. L., Avisar, E., Kosiorek, H., Dueck, A., Fortino, J., Kashani-Sabet, M., Hart, K., & Vetto, J. T. (Accepted/In press). Is pelvic sentinel node biopsy necessary for lower extremity and trunk melanomas? American Journal of Surgery. https://doi.org/10.1016/j.amjsurg.2017.03.028