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Published on: August 19, 2021
Sentinel node biopsy for head and neck melanoma: a systematic review
Nicole de Rosa1, Gary H Lyman, Damian Silbermins
1Duke University, Durham, NC, USA.
Summary
Sentinel node biopsy for head and neck melanoma has a high identification rate but also a higher false-negative rate compared to other body sites. Positive sentinel node biopsy results strongly predict recurrence.
Area of Science:
- Oncology
- Dermatology
- Surgical Pathology
Background:
- Melanoma of the head and neck presents unique diagnostic challenges.
- Sentinel node biopsy (SNB) is a crucial staging procedure for melanoma.
- Evaluating SNB performance in head and neck melanoma is essential for patient management.
Purpose of the Study:
- To systematically review the test performance of SNB in head and neck melanoma.
- To determine the identification rate and false-negative rate of SNB in this specific anatomical region.
- To assess the predictive value of SNB for nodal recurrence.
Main Methods:
- Systematic review of studies using PubMed, EMBASE, ASCO, and SSO databases.
- Inclusion criteria: SNB performed, head and neck lesions, reported recurrence data.
- Dual-blind data extraction focusing on identification rate and test performance.
Main Results:
- 32 studies (1990-2009) including 3442 patients were analyzed.
- Median SNB identification rate was 95.2%; median false-negative rate for nodal recurrence was 20.4%.
- Positive SNB status was found in 15% of patients, with 13.67% having additional positive nodes on completion dissection.
Conclusions:
- Sentinel node biopsy for head and neck melanoma demonstrates an elevated false-negative rate compared to non-head and neck sites.
- A positive sentinel node biopsy result is a strong indicator of melanoma recurrence.
- Further refinement of SNB techniques may be needed for head and neck melanoma.
