Sentinel Lymph Node Biopsy for Melanoma: American Society of Clinical Oncology and Society of Surgical Oncology Joint Clinical Practice Guideline
Sentinel Lymph Node Biopsy for Melanoma: American Society of Clinical Oncology and Society of Surgical Oncology Joint Clinical Practice Guideline
复制标题
DOI：
10.1245/s10434-012-2475-3
复制
发表时间：
2012-10-01
影响因子：
3.7
通讯作者：
Lyman, Gary H.
中科院分区：
文献类型：
--
作者：
Wong, Sandra L.;Balch, Charles M.;Lyman, Gary H.
美国临床肿瘤学会(ASCO)和外科肿瘤学会(SSO)寻求提供一个循证指南，指导淋巴标测和前哨淋巴结(SLN)活检在新诊断的黑色素瘤患者分期中的应用。ASCO和SSO年会的摘要包括在证据审查中。一个专家小组被召集来审查证据和制定指南建议。73项研究符合完全的资格标准。证据回顾表明，对于大多数新诊断的黑色素瘤患者，SLN活检是一种可接受的淋巴结分期方法。SLN活检适用于任何解剖部位的中等厚度黑色素瘤(Breslow厚度为1-4 mm)的患者；在这一人群中使用SLN活检可以提供准确的分期。虽然很少有研究聚焦于厚黑色素瘤(T4；Breslow厚度，>；4 mm)的患者，但SLN活检可能被推荐用于分期目的和促进区域疾病控制。没有足够的证据支持薄型黑色素瘤(T1；Breslow厚度，1 mm)患者的常规SLN活检，尽管当分期益处大于手术风险时，可以考虑在具有高危特征的选定患者中进行SLN活检。对于SLN活检阳性的所有患者，建议行完全淋巴清扫术(CLND)，并实现良好的区域性疾病控制。SLN活检阳性后的CLND是否提高了存活率，是正在进行的多中心选择性淋巴切除术试验II.版权所有A(C)2012美国临床肿瘤学会和外科肿瘤学会的主题。版权所有。未经美国临床肿瘤学会和外科肿瘤学会的书面许可，不得以任何形式或任何电子或机械方式复制或传播本文件的任何部分，包括影印、记录或任何信息存储和检索系统。
The American Society of Clinical Oncology (ASCO) and Society of Surgical Oncology (SSO) sought to provide an evidence-based guideline on the use of lymphatic mapping and sentinel lymph node (SLN) biopsy in staging patients with newly diagnosed melanoma.A comprehensive systematic review of the literature published from January 1990 through August 2011 was completed using MEDLINE and EMBASE. Abstracts from ASCO and SSO annual meetings were included in the evidence review. An Expert Panel was convened to review the evidence and develop guideline recommendations.Seventy-three studies met full eligibility criteria. The evidence review demonstrated that SLN biopsy is an acceptable method for lymph node staging of most patients with newly diagnosed melanoma.SLN biopsy is recommended for patients with intermediate-thickness melanomas (Breslow thickness, 1-4 mm) of any anatomic site; use of SLN biopsy in this population provides accurate staging. Although there are few studies focusing on patients with thick melanomas (T4; Breslow thickness, > 4 mm), SLN biopsy may be recommended for staging purposes and to facilitate regional disease control. There is insufficient evidence to support routine SLN biopsy for patients with thin melanomas (T1; Breslow thickness, < 1 mm), although it may be considered in selected patients with high-risk features when staging benefits outweigh risks of the procedure. Completion lymph node dissection (CLND) is recommended for all patients with a positive SLN biopsy and achieves good regional disease control. Whether CLND after a positive SLN biopsy improves survival is the subject of the ongoing Multicenter Selective Lymphadenectomy Trial II.Copyright A (c) 2012 American Society of Clinical Oncology and Society of Surgical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by the American Society of Clinical Oncology and Society of Surgical Oncology.