BACKGROUND: Any sentinel lymph node that receives lymph drainage directly from a primary melanoma site, regardless of its location, may contain metastatic disease. This is true even if the sentinel node does not lie in a recognized node field. Interval (in-transit) nodes that lie along the course of a lymphatic vessel between a primary melanoma site and a recognized node field are sometimes seen during lymphatic mapping for sentinel node biopsy. If drainage to such interval nodes is ignored by the surgeon during sentinel node biopsy, metastatic melanoma will be missed in some patients. HYPOTHESIS: When lymph drains directly from a cutaneous melanoma site to an interval node, that sentinel node has the same chance of harboring micrometastatic disease as a sentinel node in a recognized node field. DESIGN: Preoperative lymphoscintigraphy with technetiumTc 99m antimony trisulfide colloid was performed to define lymphatic drainage patterns and, since 1992, to locate the sentinel lymph nodes for surgical biopsy or for permanent skin marking of their location with point tattoos. SETTING: Melanoma unit of a university teaching hospital. PATIENTS: A total of 2045 patients with cutaneous melanoma were studied in 13 years. RESULTS: Interval nodes were found in 148 patients (7.2%). The incidence of interval nodes varied with the site of the primary melanoma. Interval nodes were more common with melanomas on the trunk than with those on the lower limbs. Micrometastatic disease was found in 14% of interval nodes that underwent biopsy as sentinel nodes. This incidence is similar to that found in sentinel nodes located in recognized node fields, confirming the potential clinical importance of interval nodes. CONCLUSIONS: Interval nodes should be removed surgically along with any additional sentinel nodes in standard node fields if the sentinel node biopsy procedure is to be complete. In some patients, an interval node will be the only lymph node that contains metastatic disease.
BACKGROUND: Any sentinel lymph node that receives lymph drainage directly from a primary melanoma site, regardless of its location, may contain metastatic disease. This is true even if the sentinel node does not lie in a recognized node field. Interval (in-transit) nodes that lie along the course of a lymphatic vessel between a primary melanoma site and a recognized node field are sometimes seen during lymphatic mapping for sentinel node biopsy. If drainage to such interval nodes is ignored by the surgeon during sentinel node biopsy, metastatic melanoma will be missed in some patients. HYPOTHESIS: When lymph drains directly from a cutaneous melanoma site to an interval node, that sentinel node has the same chance of harboring micrometastatic disease as a sentinel node in a recognized node field. DESIGN: Preoperative lymphoscintigraphy with technetiumTc 99m antimony trisulfide colloid was performed to define lymphatic drainage patterns and, since 1992, to locate the sentinel lymph nodes for surgical biopsy or for permanent skin marking of their location with point tattoos. SETTING:Melanoma unit of a university teaching hospital. PATIENTS: A total of 2045 patients with cutaneous melanoma were studied in 13 years. RESULTS: Interval nodes were found in 148 patients (7.2%). The incidence of interval nodes varied with the site of the primary melanoma. Interval nodes were more common with melanomas on the trunk than with those on the lower limbs. Micrometastatic disease was found in 14% of interval nodes that underwent biopsy as sentinel nodes. This incidence is similar to that found in sentinel nodes located in recognized node fields, confirming the potential clinical importance of interval nodes. CONCLUSIONS: Interval nodes should be removed surgically along with any additional sentinel nodes in standard node fields if the sentinel node biopsy procedure is to be complete. In some patients, an interval node will be the only lymph node that contains metastatic disease.
Authors: Hayley M Reynolds; Cameron G Walker; P Rod Dunbar; Michael J O'Sullivan; Roger F Uren; John F Thompson; Nicolas P Smith Journal: J Anat Date: 2010-01-07 Impact factor: 2.610
Authors: Annette H Chakera; Birger Hesse; Zeynep Burak; James R Ballinger; Allan Britten; Corrado Caracò; Alistair J Cochran; Martin G Cook; Krzysztof T Drzewiecki; Richard Essner; Einat Even-Sapir; Alexander M M Eggermont; Tanja Gmeiner Stopar; Christian Ingvar; Martin C Mihm; Stanley W McCarthy; Nicola Mozzillo; Omgo E Nieweg; Richard A Scolyer; Hans Starz; John F Thompson; Giuseppe Trifirò; Giuseppe Viale; Sergi Vidal-Sicart; Roger Uren; Wendy Waddington; Arturo Chiti; Alain Spatz; Alessandro Testori Journal: Eur J Nucl Med Mol Imaging Date: 2009-10 Impact factor: 9.236
Authors: Christina Bluemel; Ken Herrmann; Francesco Giammarile; Omgo E Nieweg; Julien Dubreuil; Alessandro Testori; Riccardo A Audisio; Odysseas Zoras; Michael Lassmann; Annette H Chakera; Roger Uren; Sotirios Chondrogiannis; Patrick M Colletti; Domenico Rubello Journal: Eur J Nucl Med Mol Imaging Date: 2015-07-25 Impact factor: 9.236
Authors: Stephen P Povoski; Ryan L Neff; Cathy M Mojzisik; David M O'Malley; George H Hinkle; Nathan C Hall; Douglas A Murrey; Michael V Knopp; Edward W Martin Journal: World J Surg Oncol Date: 2009-01-27 Impact factor: 2.754
Authors: L W T Alkureishi; Z Burak; J A Alvarez; J Ballinger; A Bilde; A J Britten; L Calabrese; C Chiesa; A Chiti; R de Bree; H W Gray; K Hunter; A F Kovacs; M Lassmann; C R Leemans; G Mamelle; M McGurk; J Mortensen; T Poli; T Shoaib; P Sloan; J A Sorensen; S J Stoeckli; J B Thomsen; G Trifiro; J Werner; G L Ross Journal: Ann Surg Oncol Date: 2009-11 Impact factor: 5.344
Authors: Lee W T Alkureishi; Zeynep Burak; Julio A Alvarez; James Ballinger; Anders Bilde; Alan J Britten; Luca Calabrese; Carlo Chiesa; Arturo Chiti; Remco de Bree; Harry W Gray; Keith Hunter; Adorjan F Kovacs; Michael Lassmann; C Rene Leemans; Gerard Mamelle; Mark McGurk; Jann Mortensen; Tito Poli; Taimur Shoaib; Philip Sloan; Jens A Sorensen; Sandro J Stoeckli; Jorn B Thomsen; Giusepe Trifiro; Jochen Werner; Gary L Ross Journal: Eur J Nucl Med Mol Imaging Date: 2009-11 Impact factor: 9.236