ANALYSIS OF PATIENTS SUBMITTED TO SENTINELY LYMPHONODUS RESEARCH AT A REFERENCE PUBLIC HOSPITAL IN THE PERIOD FROM 2016 TO 2018

Introduction: Melanoma is one of the less common skin neoplasms, but it is the most aggressive one own to the high incidence of metastasis. The sentinel lymph node dissection in melanoma was first proposed in 1992 as an alternative to radical lymphadenectomy previously advocated. The MSLT (Melanoma Sentinel Lymph Node Trial) I (2006) revealed the prognostic value of sentinel lymph node status. The MSLT II (2018) evaluated the usefulness of lymphadenectomy in melanoma patients, comparing follow-up by periodic imaging exams with lymphadenectomy restricted to clinical lymph node recurrence. Following patients for 43 months; radical lymphadenectomy did not increase melanoma specific-survival among patients with positive sentinel lymph node, but promoted local disease control. Objective: Evaluate the profile and follow-up of melanoma patients who underwent though sentinel lymph node dissection at a cancer reference service for the last 3 years. Methods: A review of medical records of melanoma patients submitted through sentinel lymph node dissection performed at a public oncology reference hospital from 2016 to 2018. Results: During the period, 133 melanoma patients underwent through sentinel lymph node dissection. The age at diagnosis ranged from 15 to 87 years, distributed in 64 men (48%) and 69 women (52%). Most of the primary lesions were located in the extremities (56%), followed by trunk (37%) and head/neck (7%). There was no marking in 3 of 133 patients submitted to preoperative lymphoscintigraphy and in 3 patients the sentinel lymph node was not found intraoperatively. The remaining 127 cases, presented an average of excised sentinel lymph nodes of 1.8/patient. Micrometastasis were negative in 83 (65%) and positive in 44 (35%). Considering 44 positive sentinel lymph nodes, 34 underwent to complete lymphadenectomy and 10 to a follow up the lymph node chain with imaging, following the MSLT-II. The post-lymphadenectomy follow up of 34 patients, demonstrated 6 deaths from melanoma, 7 lost follow-up, 5 patients alive with disease and 16 alive without disease. The 10 follow-up patients who were not submitted trough lymphadenectomy are alive without disease. Conclusion: Considering post-lymphadenectomy follow-up after positive sentinel node, there was a higher number of patients alive than deaths. The patients who were followed according to MSLT II guidelines, all remained alive without disease; however, there was no significant follow-up time for comparison.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019