Intraparotid Sentinel Lymph Node Dissection for Melanoma: A Systematic Review and Meta-Analysis.

Area of Science:

• Oncology
• Surgical Oncology
• Dermatology

Background:

• Head and neck cutaneous melanoma (HNCM) surgical management has advanced with sentinel lymph node biopsy (SLNB) for prognosis and staging.
• Intraparotid SLNB is increasingly utilized, necessitating evaluation against more extensive procedures like superficial parotidectomy (SP).

Purpose of the Study:

• To evaluate the safety and efficiency of intraparotid SLNB compared to superficial parotidectomy (SP) for HNCM.
• To assess complication rates and procedural success for intraparotid SLNB in N0 HNCM patients.

Main Methods:

• A meta-analysis of PubMed and Scopus databases up to March 10, 2022.
• Inclusion of institutional data from cherry-picking procedures.
• Pooled estimates calculated using random-effects model; heterogeneity assessed with I² test.

Main Results:

• Pooled SLNB excision success rate was 97% with a 4% failure rate.
• Pooled probability of a positive SLNB result was 16%.
• Intraparotid SLNB showed significantly lower risks of temporary (RR 0.12) and permanent (RR 0.46) facial nerve paralysis compared to SP.

Conclusions:

• Intraparotid SLNB is a safe and reliable procedure for N0 HNCM patients with low complication rates.
• The 4% failure rate suggests intraparotid SLNB may be advantageous over extensive surgery like SP.
• Further prospective trials are recommended to confirm the superiority of intraparotid SLNB.