Sentinel lymph node biopsy in head and neck melanoma*.

Area of Science:

• Oncology
• Dermatology
• Surgical Pathology

Background:

• Head and neck melanoma (HNM) presents unique challenges in diagnosis and treatment.
• The accuracy and utility of sentinel lymph node biopsy (SLNB) in HNM have been debated due to complex lymphatic drainage patterns.
• Understanding the prognosis and optimal surgical management for HNM is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the prognosis of patients with head and neck melanoma (HNM).
• To assess the effectiveness of surgical management strategies for HNM.
• To determine the accuracy and reliability of sentinel lymph node biopsy (SLNB) in identifying nodal metastasis in HNM.

Main Methods:

• A retrospective analysis of 680 melanoma patients treated between 1994 and 2012.
• Inclusion of 84 patients diagnosed with primary cutaneous head and neck melanoma (HNM).
• Performance of SLNB within 90 days for patients with adverse prognostic features, followed by lymphadenectomy for positive cases.

Main Results:

• Out of 680 melanoma patients, 84 (12.35%) had HNM.
• SLNB identified positive sentinel nodes in 26.3% of HNM patients.
• Recurrence-free survival and 5-year survival rates were significantly worse in the HNM cohort compared to other melanoma sites.
• The rate of unfound sentinel lymph nodes was comparable between HNM and other sites (5.26% vs. 4.92%).

Conclusions:

• Sentinel lymph node biopsy (SLNB) is a feasible and accurate technique for staging head and neck melanoma (HNM), with a high identification rate (98.25%).
• Head and neck melanoma (HNM) patients exhibit a significantly shorter prognosis compared to patients with melanomas at other sites.
• Management of HNM necessitates a multidisciplinary team approach within specialized referral centers.