Alliric I Willis1, John A Ridge. 1. Department of Surgical Oncology, Head and Neck Surgery Section, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA. ja_ridge@fccc.edu
Abstract
BACKGROUND: We analyzed the variability and accuracy of sentinel lymph node (SLN) identification by lymphoscintigraphy performed preoperatively and repeated on the day of operation in patients with melanoma or Merkel cell cancer. METHODS: Twenty-five prospectively studied patients had lymphoscintigraphy prior to and on the day of operation. Discordance between lymphoscintograms was defined as change in location of SLN or failure to identify a SLN by one of the studies. RESULTS: In 22 of 24 assessable cases (92%), SLNs were excised. Preoperative lymphoscintigraphy was correct in 19 of 22 (86%) cases. Day of operation lymphoscintigraphy was correct in 20 of 22 (91%) cases. SLN location was as classically described in 24 of 25 (96%) cases. Discordance between lymphoscintigraphy studies was 32% (8/25 patients). Half with discordant migration (8%) yielded metastases in basins not identified by day of operation lymphoscintigraphy but demonstrated by preoperative lymphoscintigraphy. CONCLUSIONS: Head and neck lymphatic drainage patterns not only vary between patients but also can vary with time for a single patient.
BACKGROUND: We analyzed the variability and accuracy of sentinel lymph node (SLN) identification by lymphoscintigraphy performed preoperatively and repeated on the day of operation in patients with melanoma or Merkel cell cancer. METHODS: Twenty-five prospectively studied patients had lymphoscintigraphy prior to and on the day of operation. Discordance between lymphoscintograms was defined as change in location of SLN or failure to identify a SLN by one of the studies. RESULTS: In 22 of 24 assessable cases (92%), SLNs were excised. Preoperative lymphoscintigraphy was correct in 19 of 22 (86%) cases. Day of operation lymphoscintigraphy was correct in 20 of 22 (91%) cases. SLN location was as classically described in 24 of 25 (96%) cases. Discordance between lymphoscintigraphy studies was 32% (8/25 patients). Half with discordant migration (8%) yielded metastases in basins not identified by day of operation lymphoscintigraphy but demonstrated by preoperative lymphoscintigraphy. CONCLUSIONS: Head and neck lymphatic drainage patterns not only vary between patients but also can vary with time for a single patient.
Authors: Benjamin Lok; Sabrina Khan; Robert Mutter; Jeffrey Liu; Ryan Fields; Melissa Pulitzer; Weiji Shi; Zhigang Zhang; Dennis Kraus; David Pfister; Klaus J Busam; Isaac Brownell; Nancy Lee Journal: Cancer Date: 2011-12-16 Impact factor: 6.860
Authors: John E Hanks; Kevin J Kovatch; S Ahmed Ali; Emily Roberts; Alison B Durham; Joshua D Smith; Carol R Bradford; Kelly M Malloy; Philip S Boonstra; Christopher D Lao; Scott A McLean Journal: Otolaryngol Head Neck Surg Date: 2020-02-11 Impact factor: 3.497