Биопсия сторожевого лимфоузла при меланоме кожи: опыт одного центра

Abstract

Evaluation of sentinel lymph node (SLN) is crucial for cutaneous melanoma staging and treatment in patients with clinically negative lymph nodes. We evaluated patients’ outcome who underwent SLN biopsy (SLNB) in NMRC of N.N. Petrov National Medical Research Center of Oncology for skin melanoma between July of 2018 and March of 2021. SLNB was performed in 310 patients with an average age of 53.6 years. 67.4% of patients were female and 32.6% were male. The stage distribution was following: pT1 – 65 (21%), pT2 – 103 (33.2%), pT3 – 84 (27%), pT4 – 58 (18.8%). SLNB was performed with excision of the primary tumor in 71 cases (22.9%), delayed – 239 (77.1%). Average amount of days between excisional biopsy and re-excision of a postoperative scar with SLNB was 44.8 (range 12 to 190 days). Metastasis was detected in 42 cases (13.5%). In 7 cases SLNB was performed simultaneously with excision of the primary skin melanoma, in 35 cases it was delayed. After detection of metastasis in SLN, 100% of patients receive immunotherapy in various modes. The median follow-up time was 13.1 months (range 1 to 27 months). In ῾negative’ SLN group there were 3 cases of regional lymph node disease (in 6, 8 and 12 months, respectively). In all cases metastasis was recorded in the lymphatic collector, in which the SLN was removed. 5 patients had true scar recurrence. SLNB is an effective method for early diagnosis of regional metastases, which allows to start systemic treatment and improve patient’s outcome.