Frequency and implications of occipital and posterior auricular sentinel lymph nodes in scalp melanoma

Published on Oct 15, 2019in Journal of Surgical Oncology2.771
· DOI :10.1002/JSO.25715
Heather Carmichael8
Estimated H-index: 8
(CU: University of Colorado Boulder),
Becky B. T. King1
Estimated H-index: 1
(CU: University of Colorado Boulder)
+ 6 AuthorsNicole Kounalakis11
Estimated H-index: 11
(Northside Hospital)
Sources
Abstract
BACKGROUND: Patients with scalp melanoma have poor oncologic outcomes compared with those with other cutaneous sites. Sentinel lymph node (SLN) biopsy provides prognostic information but is challenging in the head and neck. We explore the anatomic distribution of scalp melanoma and describe the most common sites of SLN drainage and of SLN metastatic disease. METHODS: Retrospective review of scalp melanoma patients who underwent SLN biopsy. Melanoma location was classified as frontal, coronal apex, coronal temporal, or posterior scalp. SLN location was classified by lymph node level and region. RESULTS: We identified 128 patients with scalp melanoma. The most common primary tumor location was the posterior scalp (43%) and the most frequent SLN drainage site was the level 2 lymph node basin (48%). Total 31 patients (24%) had metastatic disease in an SLN. Scalp SLNs, classified as being in the posterior auricular or occipital region, were localized in 26% of patients. For patients in which a scalp SLN was identified, 30% had a positive scalp SLN (n = 10). CONCLUSIONS: Scalp SLNs are frequent drainage sites for scalp melanoma and, when found, have a 30% chance of harboring metastatic disease. Surgeons, radiologists, and pathologists should be vigilant in identifying, removing, and analyzing scalp SLNs.
📖 Papers frequently viewed together
36 Citations
19 Citations
References30
Newest
#1Rebecca L. Siegel (ACS: American Cancer Society)H-Index: 67
#2Kimberly D. Miller (ACS: American Cancer Society)H-Index: 28
Last. Ahmedin Jemal (ACS: American Cancer Society)H-Index: 139
view all 3 authors...
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2014, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2015, were collected by the Nation...
10.5k CitationsSource
#1Charles Xie (Monash University)H-Index: 4
#2Yan Pan (Alfred Hospital)H-Index: 8
Last. John W Kelly (Alfred Hospital)H-Index: 29
view all 6 authors...
Background Scalp melanomas have more aggressive clinicopathological features than other melanomas and mortality rates more than twice that of melanoma located elsewhere. Objective We sought to describe the survival of patients with scalp melanoma versus other cutaneous head and neck melanoma (CHNM), and explore a possible independent negative impact of scalp location on CHNM survival. Methods A retrospective cohort study was performed of all invasive primary CHNM cases seen at a tertiary referra...
12 CitationsSource
#1Camille L. Stewart (University of Colorado Denver)H-Index: 13
#2Ana Gleisner (University of Colorado Denver)H-Index: 23
Last. Nicole Kounalakis (University of Colorado Denver)H-Index: 11
view all 8 authors...
Background Sentinel lymph node biopsy (SLNB) for head and neck melanoma is challenging due to unpredictable drainage. We sought to determine the frequency of drainage to multiple lymphatic basins and asked if this was associated with prognosis in a large, single-center cohort.
7 CitationsSource
#1Francis X. Creighton (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 10
#2Regan W. Bergmark (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 15
Last. Kevin S. Emerick (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 20
view all 3 authors...
Objectives(1) Determine the frequency of nontraditional sentinel lymph node (SLN) locations in cutaneous head and neck malignancy and (2) determine the frequency of level IIB SLNs in cutaneous head and neck malignancy.DesignCase series with chart review.SettingTertiary academic hospital.Subjects and MethodsIn total, 145 consecutive sentinel lymph node biopsy (SLNB) specimens for cutaneous head and neck malignancies were reviewed from 2007 to 2015. Nodal regions were categorized into levels I to ...
13 CitationsSource
#1Marcus M. Monroe (UofU: University of Utah)H-Index: 15
#2Prasanth Pattisapu (University of Texas at Austin)H-Index: 2
Last. Michael E. KupfermanH-Index: 23
view all 4 authors...
ObjectivesSentinel lymph node biopsy (SLNB) is standard practice for intermediate-thickness head and neck melanoma (HNM) but remains controversial for melanomas more than 4 mm in thickness. The objectives of this study were to evaluate (1) the diagnostic accuracy and (2) the prognostic value of SLNB in patients with thick HNM.Study DesignCase series with chart review.SettingLarge cancer center between June 2000 and December 2012.Subjects77 patients undergoing SLNB for T4 HNM without in-transit, ...
13 CitationsSource
#1Ulrike Leiter (University of Tübingen)H-Index: 41
#2Thomas Eigentler (University of Tübingen)H-Index: 58
Last. Claus Garbe (University of Tübingen)H-Index: 114
view all 10 authors...
Background Sentinel lymph node biopsy (SLNB) plays an important role in the prognostic classification of melanoma and is now a standard staging procedure. However, due to the complex drainage pattern and the risk of site associated morbidity, the potential survival benefit of SLNB is controversial in head and neck (H&N) melanoma.
19 CitationsSource
#1Breanne E. Terakedis (UofU: University of Utah)H-Index: 5
#2Christopher J. Anker (UofU: University of Utah)H-Index: 13
Last. Dennis C. Shrieve (UofU: University of Utah)H-Index: 55
view all 12 authors...
Background Patients with melanoma of the scalp may have higher failure (recurrence) rates than melanoma of other body sites. Objective We sought to characterize survival and patterns of failure for patients with scalp melanoma. Methods Between 1998 and 2010, 250 nonmetastatic patients underwent wide local excision of a primary scalp melanoma. Kaplan-Meier analyses were performed to evaluate overall survival, scalp control, regional neck control, distant metastases–free survival, and disease-free...
20 CitationsSource
#1Zachary J. Cappello (University of Louisville)H-Index: 3
#2Adam C. Augenstein (University of Louisville)H-Index: 3
Last. Jeffrey M. Bumpous (University of Louisville)H-Index: 22
view all 5 authors...
Objectives/Hypothesis To compare clinicopathologic and prognostic factors associated with scalp melanomas and nonscalp melanomas of the head and neck (H&N). Study Design Post hoc analysis of the database from a multi-institutional, prospective, randomized study. Methods Clinicopathologic factors were assessed and correlated with survival and recurrence. Univariate and multivariate analysis of prognostic factors affecting disease-free survival and overall survival were performed. Results Of 405 p...
17 CitationsSource
#1Vincenzo De Giorgi (UniFI: University of Florence)H-Index: 42
#2Susanna RossariH-Index: 15
Last. Daniela MassiH-Index: 64
view all 8 authors...
Cutaneous melanoma is a malignant neoplasia with several demographic and histopathological prognostic factors. Many studies stress that the head and neck region has a worse prognosis compared with other localizations, but the reasons for this worse prognosis are unclear. Therefore, the aim of our study is to analyse the poor prognosis of head and neck melanoma (HNM) with respect to the other anatomical sites, considering the face and neck (FN P=0.05). Moreover, on analysing the two anatomical ar...
35 CitationsSource
#1Sandra L. Wong (UM: University of Michigan)H-Index: 51
#2Charles M. Balch (UTSW: University of Texas Southwestern Medical Center)H-Index: 12
Last. Gary H. Lyman (Duke University)H-Index: 117
view all 15 authors...
Purpose The American Society of Clinical Oncology (ASCO) and Society of Surgical Oncology (SSO) sought to provide an evidence-based guideline on the use of lymphatic mapping and sentinel lymph node (SLN) biopsy in staging patients with newly diagnosed melanoma. Methods A comprehensive systematic review of the literature published from January 1990 through August 2011 was completed using MEDLINE and EMBASE. Abstracts from ASCO and SSO annual meetings were included in the evidence review. An Exper...
240 CitationsSource
Cited By4
Newest
#1Gaetano LicataH-Index: 2
Last. Elvira Moscarella (Seconda Università degli Studi di Napoli)H-Index: 16
view all 7 authors...
Source
#1Reza Assadsangabi (UC Davis: University of California, Davis)
#2Rosa Babaei (UPenn: University of Pennsylvania)
Last. Seyed Ali Nabavizadeh (UPenn: University of Pennsylvania)H-Index: 11
view all 7 authors...
Involvement of lymph nodes in patients with head and neck cancers impacts treatment and prognosis. Head and neck lymph nodes are comprised of superficial and deep groups which are interconnected. The deep lymph nodes, predominantly centered along internal jugular veins, are very well-known to radiologists and clinicians. However, superficial lymph nodes that drain lymph from the scalp, face, and neck are much less recognized. Here, we describe the anatomic and imaging features of these superfici...
Source
#1Muhammad SaaiqH-Index: 1
#2Iris Zalaudek (UniTS: University of Trieste)H-Index: 74
Last. Mohamad Goldust (Sapienza University of Rome)H-Index: 17
view all 12 authors...
Melanoma constitutes one of the most sinister and troublesome malignancies encountered by humanity. Generally, the diagnosis of advanced melanoma connotes a grave prognosis, prompting a sense of looming threat of death, however the early-stage detected disease responds well to robust treatment resulting in reasonable survivorship. Scalp melanomas are even more troublesome, because they typically exhibit more aggressive biologic behavior and are often diagnosed at a late stage. This review tries ...
2 CitationsSource