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Epitrochlear sentinel lymph nodes in melanoma: interval or independent?
Travis B Kidner1, Jeong L Yoon, Mark B Faries
1Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California, USA.
The American Surgeon
|May 31, 2012
Summary
Epitrochlear lymph nodes in the arm function similarly to axillary lymph nodes for melanoma drainage. Patients with positive epitrochlear sentinel lymph node biopsy results require axillary dissection.
Area of Science:
- Oncology
- Surgical Pathology
- Dermatology
Background:
- Melanoma metastasis typically involves axillary lymph nodes for distal upper extremity tumors.
- Epitrochlear lymph node involvement is less common but its relationship with axillary drainage is not well understood.
Purpose of the Study:
- To investigate the drainage patterns of epitrochlear sentinel lymph nodes (SLNs) in patients with distal upper extremity melanoma.
- To determine the relationship between epitrochlear and axillary lymph node basins in melanoma metastasis.
Main Methods:
- Retrospective analysis of a melanoma database.
- Identification of patients who underwent sentinel lymph node biopsy for distal upper extremity melanoma.
- Analysis of patient demographics, tumor characteristics, nodal drainage patterns, and SLN metastasis incidence.
Main Results:
- 14.9% of patients had an epitrochlear SLN; all had concurrent axillary drainage.
- Of 38 patients with epitrochlear SLNs, 5.2% had metastasis in both basins, 10.5% in epitrochlear only, and 10.5% in axillary only.
- 73.7% of patients had tumor-free SLNs.
Conclusions:
- The epitrochlear SLN functions in an interval role with the axillary lymph node basin for upper extremity melanomas.
- Concurrent axillary dissection is recommended for all patients with a positive epitrochlear SLN.
