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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2010.9
- 수록면
- 163 - 172 (10page)
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Purpose: The aim of this study was to evaluate the usefulness of sentinel lymph node (SLN) biopsy in the treatment of primary melanoma.
Methods: Fifty-one cases that were diagnosed as malignant melanoma of the skin without clinical evidence of regional lymph node metastasis and underwent SLN biopsy at Samsung Medical Center were analyzed retrospectively. A lymphoscintigraphy with peritumoral injection of radionuclide was performed preoperatively. SLNs were identified using a hand-held gamma probe and by methylene blue dye injection intraoperatively.
Results: Twenty patients (39%) had metastasis in the SLN and they underwent immediate complete radical dissection of the nodal basin. Among the 20 patients who had SLN metastasis, additional metastatic lymph nodes were detected in 5 patients after the complete lymph node dissection. When several clinico-pathologic parameters such as gender, age, primary tumor location, draining nodal basin, tumor depth and size of tumor were compared between SLN positive group and negative group, there was a significant difference in the mean thickness of melanoma between SLN (＋) group (5±2.9 ㎜) and SLN (?) group (4.5±5.0 ㎜) (P＜0.05). In the same way, as the thickness of melanoma increased, positive SLN were detected more frequently (P＜0.05). Recurrences occurred in 18 patients (35.3%) during the follow-up period, but only one case in 31 patients with negative SLN recurred at the SLN basin without evidence of distant or loco-regional recurrence (false negative rate 4.8%). Lymphedema of extremity developed in 9 patients who underwent complete radical lymph node dissection and 2 patients who underwent only SLN biopsy had a very mild-form lymphedema.
Conclusion: SLN biopsy in the treatment of cutaneous melanoma is a safe, useful and feasible method to identify status of regional lymph node with low false negative rates and low complications.
Methods: Fifty-one cases that were diagnosed as malignant melanoma of the skin without clinical evidence of regional lymph node metastasis and underwent SLN biopsy at Samsung Medical Center were analyzed retrospectively. A lymphoscintigraphy with peritumoral injection of radionuclide was performed preoperatively. SLNs were identified using a hand-held gamma probe and by methylene blue dye injection intraoperatively.
Results: Twenty patients (39%) had metastasis in the SLN and they underwent immediate complete radical dissection of the nodal basin. Among the 20 patients who had SLN metastasis, additional metastatic lymph nodes were detected in 5 patients after the complete lymph node dissection. When several clinico-pathologic parameters such as gender, age, primary tumor location, draining nodal basin, tumor depth and size of tumor were compared between SLN positive group and negative group, there was a significant difference in the mean thickness of melanoma between SLN (＋) group (5±2.9 ㎜) and SLN (?) group (4.5±5.0 ㎜) (P＜0.05). In the same way, as the thickness of melanoma increased, positive SLN were detected more frequently (P＜0.05). Recurrences occurred in 18 patients (35.3%) during the follow-up period, but only one case in 31 patients with negative SLN recurred at the SLN basin without evidence of distant or loco-regional recurrence (false negative rate 4.8%). Lymphedema of extremity developed in 9 patients who underwent complete radical lymph node dissection and 2 patients who underwent only SLN biopsy had a very mild-form lymphedema.
Conclusion: SLN biopsy in the treatment of cutaneous melanoma is a safe, useful and feasible method to identify status of regional lymph node with low false negative rates and low complications.
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REFERENCES
참고문헌 (30)
참고문헌 신청
1. [학술지(정기간행물)] - Jemal A / 2008 / Cancer statistics, 2008 / CA Cancer J Clin 58 : 71 ~ 96
2. [학술지(정기간행물)] - 배종면 / 2008 / 한국 8개 지역암등록본부 자료를 활용한 2000-2002년 한국인 국가 암통계 추정 / 예방의학회지 41 (6) : 380 ~ 386
3. [학술지(정기간행물)] - Gershenwald JE / 1999 / Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients / J Clin Oncol 17 : 976 ~ 983
4. [학술지(정기간행물)] - Balch CM / 2001 / Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system / J Clin Oncol 19 : 3622 ~ 3634
5. [학술지(정기간행물)] - Sim FH / 1986 / Lymphadenectomy in the management of stage I malignant melanoma: a prospective randomized study / Mayo Clin Proc 61 : 697 ~ 705
2. [학술지(정기간행물)] - 배종면 / 2008 / 한국 8개 지역암등록본부 자료를 활용한 2000-2002년 한국인 국가 암통계 추정 / 예방의학회지 41 (6) : 380 ~ 386
3. [학술지(정기간행물)] - Gershenwald JE / 1999 / Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients / J Clin Oncol 17 : 976 ~ 983
4. [학술지(정기간행물)] - Balch CM / 2001 / Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system / J Clin Oncol 19 : 3622 ~ 3634
5. [학술지(정기간행물)] - Sim FH / 1986 / Lymphadenectomy in the management of stage I malignant melanoma: a prospective randomized study / Mayo Clin Proc 61 : 697 ~ 705
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