An 11-year analysis of head and neck melanomas following Sentinel lymph node biopsy

Published Date: 26th June 2019

Publication Authors: Barnes J, Howes A, Shaaban H, Touil L

Conference Abstract

Purpose: A long-term follow-up analysis of head and neck melanoma (HNM) patients undergoing sentinel lymph node biopsy (SLNB), their outcomes, looking specifically at differences between mapping performed the day before, or of surgery.

Method(s): A retrospective study of all patients undergoing SLNB for HNM from 25/10/2006 - 27/12/2017, in a regional Plastic Surgery Unit in Merseyside, was performed.

Result(s): Total of 213 patients underwent SLN mapping for HNM within the study period [62% (n = 132) male and 32% (n = 81) female]. 4.7% (n = 10) of patients, the Breslow Thickness (BT) was <1 mm; 45.1% (n = 96) had 1-2 mm; 32.9% (n = 70) had 2.1-4 mm; 16% (n = 34) had > 4 mml; and in 1.4% (n = 3) of patients the BT was not recorded. 23% of patients (n = 49) were mapped the day before surgery, and 77% (n = 164) on the same day.

Analysis of the number of mapped versus retrieved nodes revealed no overall differences in these groups (24% vs. 27%), respectively. 8.5% (n = 18) of patients had a positive SLNB. 89% (n = 16) subsequently underwent complete lymph node dissection (CLND) and 11% (n = 2) declined. In 88.9% of patients (n = 189) the SLN was negative with false positive rate of 9.5%. The mortality rate was 14% (n = 30).

Conclusion(s): We found no differences when patients were mapped prior to surgery, for logistics, in comparison with those mapped on the same day and therefore conclude that this is safe and reliable practice. The majority of discrepancies were due to difficulties in mapping and procedures being abandoned intraoperatively, due to risk to key structures, i.e. the facial nerve.

Touil, L; Barnes, J; Howes, A; Harper-Machin, A; Shaaban, H. (2019). An 11-year analysis of head and neck melanomas following Sentinel lymph node biopsy. Nuclear medicine communications . 40 (4), p422-423.

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