Sentinel node biopsy in vulvar and vaginal melanoma: Presentation of six cases and a literature review
Sentinel node biopsy in vulvar and vaginal melanoma: Presentation of six cases and a literature review
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DOI：
10.1007/bf02557519
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发表时间：
2002-11-01
影响因子：
3.7
通讯作者：
Slingluff, CL
中科院分区：
文献类型：
--
作者：
Abramova, L;Parekh, J;Slingluff, CL
背景：泌尿生殖道黑色素瘤是一种罕见的肿瘤，预后差。其管理在过去涉及根治性外阴切除术和完全双侧腹股沟股淋巴结切除术。前哨淋巴结活检是一个准确的低发病率的程序时，在皮肤黑色素瘤的背景下使用。然而，预防性淋巴结切除术尚未显示出改善黑色素瘤患者的生存率。我们要确定的可行性，前哨淋巴结活检的女性泌尿生殖道黑色素瘤患者作为一个stagingprocedure.Methods：6例外阴或阴道黑色素瘤进行术前淋巴映射与Tc-99 m标记的硫胶体前哨淋巴结切除术。此外，我们回顾了前哨淋巴结活检在泌尿生殖道melanoma.Results的应用的文献：一个或多个前哨淋巴结被确定在所有6例患者的淋巴结造影。所有患者均接受前哨淋巴结切除术，除了1例阴道深部黑色素瘤引流至盆腔淋巴结的患者。成功的5例均为单侧引流。切除的前哨淋巴结均无肿瘤浸润。结论：本研究结合文献报道的少数病例，支持前哨淋巴结活检对外阴和阴道黑色素瘤的诊断价值。
Background: Urogenital melanoma is a rare neoplasm with poor prognosis. Its management in the past involved radical vulvectomy and complete bilateral inguinofemoral lymphadenectomy. Sentinel lymph node biopsy is an accurate low-morbidity procedure when used in the context of cutaneous melanoma. However, prophylactic lymphadenectomy has not been shown to improve survival of melanoma patients. We wanted to determine the feasibility of sentinel lymph node biopsy in patients with female urogenital melanoma as a staging procedure.Methods: Six patients with vulvar or vaginal melanomas underwent preoperative lymphatic mapping with Tc-99m-labeled sulfur colloid followed by sentinel lymphadenectomy. In addition, we reviewed the literature on the application of sentinel lymph node biopsy in urogenital tract melanomas.Results: One or more sentinel nodes were identified in all six patients by lymphoscintigraphy. All patients underwent sentinel lymphadenectomy, except for one patient with a deep vaginal melanoma that drained to pelvic nodes. The five successful cases had unilateral drainage patterns. None of the sentinel lymph nodes excised had tumor invasion. Combined with five other patients from the published literature, the success rate of localizing sentinel lymph nodes in the patients with urogenital melanoma approaches 100%.Conclusions: This experience, plus reports of a small number of patients from three similar studies, supports the impression that sentinel lymph node biopsy is feasible for vulvar and vaginal melanoma.