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Outcomes of Non-Visualization of Sentinel Lymph Node in Melanoma
Subichin, Michael; Azouz, Vitalli; Cervino, Lawrence
Summa Health System
2019-02-15
Presenter: Michael Subichin
Affidavit:
This project has been entirely the original work of the resident. He was the central person in the conceptualization, protocol development, IRB approval, and data collection/analysis.
Director Name: Douglas Wagner MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction
Sentinel lymph node biopsy has become crucial in the management of melanoma when the depth of invasion is at least 1 millimeter or when high risk features are present. A small subset of patients have non-visualization of sentinel lymph node on lymphoscintigraphy and at the time of surgery. The implications of this remain unclear. We sought to determine patient outcomes for patients with non-visualization of a sentinel node compared to patients with visualized sentinel node.
Patients and Methods
A retrospective review of melanoma patients at a single center from 2013 through 2017 was performed identifying 1330 patients. Of these, 523 patients underwent preoperative lymphoscintigraphy for sentinel lymph node biopsy and 22 patients had non-visualized sentinel node on lymphoscintigraphy and surgical exploration. Patient demographics, pathology characteristics, and local or distant melanoma recurrence were collected to compare non-visualization to visualized sentinel node. Student's t test and chi square were used for all analysis.
Results
All 22 patients with non-visualization of sentinel node were included for analysis. Patients had follow up for an average of 26 months postoperatively. Patients with non-visualization were older (73 vs 61 p<0.05) and less likely to have recurrence (4% vs 16% p<0.05) than patients with sentinel node visualization. There was no significant differences in gender, pathologic subtype, melanoma thickness, and follow up between groups.
Conclusion
Our experience demonstrates that patients with non-visualization of sentinel lymph node in melanoma are older, have similar pathology characteristics, and have a lower recurrence rate than patients with visualized sentinel node.
