European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 5, pp 1271–1279 | Cite as

Sentinel lymph node biopsy in cutaneous head and neck melanoma

  • D. Evrard
  • E. Routier
  • C. Mateus
  • G. Tomasic
  • J. Lombroso
  • F. Kolb
  • C. Robert
  • A. Moya-Plana
Head and Neck
  • 71 Downloads

Abstract

Purpose

Sentinel lymph node biopsy (SLNB) is now a standard of care for cutaneous melanoma, but it is still controversial for cutaneous head and neck melanoma (CHNM). This study aims to confirm the feasibility, accuracy and low morbidity of SLNB in CHNM and evaluate its prognostic value.

Methods

A monocentric and retrospective study on patients with CHNM treated in our tertiary care center (Gustave Roussy) between January 2008 and December 2012 was performed. The feasibility, morbidity and prognostic value of this technique were analysed.

Results

One hundred and twenty-four consecutive patients were included. SLNB was realized in 97.6% of the cases. No significant post-operative morbidity was observed. Nineteen percents of patients had a positive SN while only 14.3% of complete lymph node dissections (CLND) had additional nodal metastasis. The risk of recurrence after positive SN was significantly higher (69.2 vs 30.8%, p = 0.043). The false omission rate was low with 7.1%. Overall survival and disease-free survival were better in the negative SN group (82 vs 49%, p < 0.001 and 69.3 vs 41.8%, p = 0.0131). The risk of recurrence was significantly higher in the positive SN group (p = 0.043) and when primary tumour was ulcerated (p = 0.031). Only the mitotic rate of the primary tumour was associated with SN positivity (p = 0.049).

Conclusion

As in other sites, SLNB status is a strong prognostic factor with comparable false omission rate and no superior morbidity.

Keywords

Cutaneous melanoma Sentinel node biopsy Head and neck Micrometastasis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies performed on animals by any of the authors.

Informed consent

Informed consent was obtained from all participants included in the study.

References

  1. 1.
    Eggermont AMM, Spatz A, Robert C (2014) Cutaneous melanoma. Lancet 383:816–827.  https://doi.org/10.1016/S0140-6736(13)60802-8 CrossRefPubMedGoogle Scholar
  2. 2.
    Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR, Buzaid AC, Cochran AJ, Coit DG, Ding S, Eggermont AM, Flaherty KT, Gimotty PA, Kirkwood JM, McMasters KM, Mihm MC, Morton DL, Ross MI, Sober AJ, Sondak VK (2009) Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 27:6199–6206.  https://doi.org/10.1200/JCO.2009.23.4799 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Nieweg OE, Roses DF, Hoekstra HJ, Karakousis CP, Puleo CA, Coventry BJ, Kashani-Sabet M, Smithers BM, Paul E, Kraybill WG, McKinnon JG, Wang HJ, Elashoff R, Faries MB, MSLT Group (2014) Final trial report of sentinel-node biopsy versus nodal observation in melanoma. N Engl J Med 370:599–609.  https://doi.org/10.1056/NEJMoa1310460 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Hafström A, Romell A, Ingvar C, Wahlberg P, Greiff L (2016) Sentinel lymph node biopsy staging for cutaneous malignant melanoma of the head and neck. Acta Otolaryngol 136:312–318.  https://doi.org/10.3109/00016489.2015.1113559 CrossRefPubMedGoogle Scholar
  5. 5.
    Tanis PJ, Nieweg OE, van den Brekel MWM, Balm AJM (2008) Dilemma of clinically node-negative head and neck melanoma: outcome of “watch and wait” policy, elective lymph node dissection, and sentinel node biopsy—a systematic review. Head Neck 30:380–389.  https://doi.org/10.1002/hed.20749 CrossRefPubMedGoogle Scholar
  6. 6.
    Davis-Malesevich MV, Goepfert R, Kubik M, Roberts DB, Myers JN, Kupferman ME (2015) Recurrence of cutaneous melanoma of the head and neck after negative sentinel lymph node biopsy. Head Neck 37:1116–1121.  https://doi.org/10.1002/hed.23718 CrossRefPubMedGoogle Scholar
  7. 7.
    Morton DL, Wen DR, Foshag LJ, Essner R, Cochran A (1993) Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol 11:1751–1756.  https://doi.org/10.1200/JCO.1993.11.9.1751 CrossRefPubMedGoogle Scholar
  8. 8.
    O’Brien CJ, Uren RF, Thompson JF, Howman-Giles RB, Petersen-Schaefer K, Shaw HM, Quinn MJ, McCarthy WH (1995) Prediction of potential metastatic sites in cutaneous head and neck melanoma using lymphoscintigraphy. Am J Surg 170:461–466.  https://doi.org/10.1016/S0002-9610(99)80330-4 CrossRefPubMedGoogle Scholar
  9. 9.
    Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Elashoff R, Essner R, Nieweg OE, Roses DF, Hoekstra HJ, Karakousis CP, Reintgen DS, Coventry BJ, Glass EC, Wang HJ, MSLT Group (2006) Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 355:1307–1317.  https://doi.org/10.1056/NEJMoa060992 CrossRefPubMedGoogle Scholar
  10. 10.
    Erman AB, Collar RM, Griffith KA, Lowe L, Sabel MS, Bichakjian CK, Wong SL, McLean SA, Rees RS, Johnson TM, Bradford CR (2012) Sentinel lymph node biopsy is accurate and prognostic in head and neck melanoma. Cancer 118:1040–1047.  https://doi.org/10.1002/cncr.26288 CrossRefPubMedGoogle Scholar
  11. 11.
    Schmalbach CE, Bradford CR (2015) Is sentinel lymph node biopsy the standard of care for cutaneous head and neck melanoma? Laryngoscope 125:153–160.  https://doi.org/10.1002/lary.24807 CrossRefPubMedGoogle Scholar
  12. 12.
    Alex JC, Krag DN, Harlow SP, Meijer S, Loggie BW, Kuhn J, Gadd M, Weaver DL (1998) Localization of regional lymph nodes in melanomas of the head and neck. Arch Otolaryngol Head Neck Surg 124:135–140.  https://doi.org/10.1001/archotol.124.2.135 CrossRefPubMedGoogle Scholar
  13. 13.
    Jansen L, Koops HS, Nieweg OE, Doting MH, Kapteijn BA, Balm AJ, Vermey A, Plukker JT, Hoefnagel CA, Piers DA, Kroon BB (2000) Sentinel node biopsy for melanoma in the head and neck region. Head Neck 22:27–33. https://doi.org/10.1002/(SICI)1097-0347(200001)22:1<27::AID-HED5>3.0.CO;2-ZCrossRefPubMedGoogle Scholar
  14. 14.
    Schmalbach CE, Nussenbaum B, Rees RS, Schwartz J, Johnson TM, Bradford CR (2003) Reliability of sentinel lymph node mapping with biopsy for head and neck cutaneous melanoma. Arch Otolaryngol Head Neck Surg 129:61–65.  https://doi.org/10.1001/archotol.129.1.61 CrossRefPubMedGoogle Scholar
  15. 15.
    Wagner JD, Park HM, Coleman JJ, Love C, Hayes JT (2000) Cervical sentinel lymph node biopsy for melanomas of the head and neck and upper thorax. Arch Otolaryngol Head Neck Surg 126:313–321.  https://doi.org/10.1001/archotol.126.3.313 CrossRefPubMedGoogle Scholar
  16. 16.
    Wells KE, Rapaport DP, Cruse CW, Payne W, Albertini J, Berman C, Lyman GH, Reintgen DS (1997) Sentinel lymph node biopsy in melanoma of the head and neck. Plast Reconstr Surg 100:591–594.  https://doi.org/10.1097/00006534-199709000-00006 CrossRefPubMedGoogle Scholar
  17. 17.
    Chao C, Martin RCG, Ross MI, Reintgen DS, Edwards MJ, Noyes RD, Hagendoorn LJ, Stromberg AJ, McMasters KM (2004) Correlation between prognostic factors and increasing age in melanoma. Ann Surg Oncol 11:259–264.  https://doi.org/10.1245/ASO.2004.04.015 CrossRefPubMedGoogle Scholar
  18. 18.
    Carlson GW, Page AJ, Cohen C, Parker D, Yaar R, Li A, Hestley A, Delman KA, Murray DR (2008) Regional recurrence after negative sentinel lymph node biopsy for melanoma. Ann Surg 248:378–386.  https://doi.org/10.1097/SLA.0b013e3181855718 PubMedGoogle Scholar
  19. 19.
    de Rosa N, Lyman GH, Silbermins D, Valsecchi ME, Pruitt SK, Tyler DM, Lee WT (2011) Sentinel node biopsy for head and neck melanoma: a systematic review. Otolaryngol Head Neck Surg 145:375–382.  https://doi.org/10.1177/0194599811408554 CrossRefPubMedGoogle Scholar
  20. 20.
    Kaveh AH, Seminara NM, Barnes MA, Berger AJ, Chen FW, Yao M, Johnson D, Parsa S, Quon A, Swetter SM, Sunwoo JB (2016) Aberrant lymphatic drainage and risk for melanoma recurrence after negative sentinel node biopsy in middle-aged and older men. Head Neck 38(Supplement 1):E754–E760.  https://doi.org/10.1002/hed.24094 CrossRefPubMedGoogle Scholar
  21. 21.
    Ophuis CM, van Akkooi AC, Rutkowski P, Voit CA, Stepniak J, Erler NS, Eggermont AM, Wouters MW, Grünhagen DJ, Verhoef CK (2016) Effects of interval between primary melanoma excision and sentinel node biopsy on positivity rate and survival. Eur J Cancer 67:164–173.  https://doi.org/10.1016/j.ejca.2016.08.014 CrossRefGoogle Scholar
  22. 22.
    Warycha MA, Zakrzewski J, Ni Q, Shapiro RL, Berman RS, Pavlick AC, Polsky D, Mazumdar M, Osman I (2009) Meta-analysis of sentinel lymph node positivity in thin melanoma (< or = 1 mm). Cancer 115:869–879.  https://doi.org/10.1002/cncr.24044 CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Gyorki DE, Boyle JO, Ganly I, Morris L, Shaha AR, Singh B, Wong RJ, Shah JP, Busam K, Kraus D, Coit DG, Patel S (2014) Incidence and location of positive nonsentinel lymph nodes in head and neck melanoma. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 40:305–310.  https://doi.org/10.1016/j.ejso.2013.11.017 Google Scholar
  24. 24.
    Cochran AJ, Huang RR, Lee J, Itakura E, Leong SP, Essner R (2006) Tumour-induced immune modulation of sentinel lymph nodes. Nat Rev Immunol 6:659–670.  https://doi.org/10.1038/nri1919 CrossRefPubMedGoogle Scholar
  25. 25.
    Leong SPL, Accortt NA, Essner R, Ross M, Gershenwald JE, Pockaj B, Hoekstra HJ, Garberoglio C, White RL, Chu D, Biel M, Charney K, Wanebo H, Avisar E, Vetto J, Soong SJ, Sentinel Lymph Node Working Group (2006) Impact of sentinel node status and other risk factors on the clinical outcome of head and neck melanoma patients. Arch Otolaryngol Head Neck Surg 132:370–373.  https://doi.org/10.1001/archotol.132.4.370 CrossRefPubMedGoogle Scholar
  26. 26.
    Eggermont AMM, Chiarion-Sileni V, Grob JJ, Dummer R, Wolchok JD, Schmidt H, Hamid O, Robert C, Ascierto PA, Richards JM, Lebbé C, Ferraresi V, Smylie M, Weber JS, Maio M, Bastholt L, Mortier L, Thomas L, Tahir S, Hauschild A, Hassel JC, Hodi FS, Taitt C, de Pril V, de Schaetzen G, Suciu S, Testori A (2016) Prolonged survival in Stage III melanoma with Ipilimumab adjuvant therapy. N Engl J Med 375:1845–1855.  https://doi.org/10.1056/NEJMoa1611299 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Head and Neck Surgery DepartmentGustave Roussy Cancer Campus, Paris Sud UniversityVillejuifFrance
  2. 2.Onco-dermatology DepartmentGustave Roussy Cancer Campus, Paris Sud University, Saclay UniversityVillejuifFrance
  3. 3.Pathology DepartmentGustave Roussy Cancer Campus, Paris Sud UniversityVillejuifFrance
  4. 4.Nuclear Medicine DepartmentGustave Roussy Cancer Campus, Paris Sud UniversityVillejuifFrance
  5. 5.Plastic and Reconstructive Surgery DepartmentGustave Roussy Cancer Campus, Paris Sud UniversityVillejuifFrance

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