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Practice patterns for positive sentinel lymph node in head and neck melanoma.
Ilyes Berania1,2, Sharon Tzelnick1,2, John R de Almeida1,2
1Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Head & Neck
|December 13, 2022
Summary
Nearly half of head and neck surgeons surveyed would perform completion lymph node dissection (CLND) after sentinel lymph node biopsy for melanoma. This indicates a potential shift from previous practices, warranting further study into variations in care.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- Investigates surgeon preferences for completion lymph node dissection (CLND) in head and neck melanomas.
- Utilizes a survey distributed through the American Society of Head & Neck Surgery (AHNS) and Canadian Society of Otolaryngology-Head and Neck Surgery (CSO).
Observation:
- A hypothetical case of a T3bN0 cheek melanoma with a positive sentinel lymph node (SLN) was presented to 149 surgeons.
- 48.3% of respondents indicated they would perform CLND, citing reasons like multiple positive SLNs, deposit size, and patient compliance.
- Surgeons with access to immunotherapy were less likely to recommend CLND.
Findings:
- Nearly half of surveyed head and neck surgeons would recommend CLND post-SLN biopsy.
- This practice contrasts with melanoma management in other anatomical sites.
- A trend away from completion neck dissection appears to be emerging compared to earlier studies.
Implications:
- Highlights significant practice variations in head and neck melanoma management.
- Suggests a potential shift in treatment paradigms for melanoma.
- Underscores the need for further research to understand and address these practice variations.
