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Parotid selective lymphadenectomy in malignant melanoma
K E Wells1, W K Stadelmann, D P Rapaport
1Division of Plastic Surgery, University of South Florida College of Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
Annals of Plastic Surgery
|July 14, 1999
Summary
Selective lymphadenectomy is a safe and effective method for staging head and neck melanoma. This procedure accurately identifies metastatic cancer in parotid lymph nodes, avoiding unnecessary surgeries.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- Malignant melanoma of the head and neck can spread to parotid lymph nodes.
- Superficial parotidectomy with facial nerve dissection was the historical approach for assessing these nodes.
- Selective lymphadenectomy offers a less invasive staging method.
Purpose of the Study:
- To evaluate the safety and efficacy of parotid selective lymphadenectomy for staging localized head and neck melanoma.
- To compare the success rates of different lymphadenectomy techniques.
Main Methods:
- Intraoperative lymphatic mapping and sentinel lymph node (SLN) biopsy were performed in 28 patients.
- Techniques included blue dye alone and a combination of blue dye with radiocolloid mapping.
- Outcomes were compared based on the mapping method used.
Main Results:
- The overall success rate for parotid selective lymphadenectomy was 86% (24/28 patients).
- Combining blue dye and radiocolloid mapping yielded a 95% success rate (21/22 patients).
- No patients experienced facial nerve injury; regional recurrence was 7% (2/28).
Conclusions:
- Parotid selective lymphadenectomy is a safe and reliable alternative to superficial parotidectomy for staging head and neck melanoma.
- Combined blue dye and radiocolloid mapping significantly improves SLN identification success.
- This technique allows for accurate staging while minimizing morbidity.