Minimal-Access Surgery for Staging of Malignant Melanoma

David N. Krag, Sybren J. Meijer, Donald L. Weaver, Brian W. Loggie, Seth P. Harlow, Kenneth K. Tanabe, Edward H. Laughlin, James C. Alex

Research output: Contribution to journalArticle

399 Citations (Scopus)

Abstract

To develop a simple, minimally invasive technique of determining whether regional node metastasis has occurred in patients with melanoma. Teaching hospital tertiary care and private practice settings. Between February 1993 and October 1994, 121 patients with invasive malignant melanoma and clinically negative lymph nodes were enrolled in this clinical trial. Consecutive sample clinical trial. Within 24 hours prior to lymph node resection, a radioactive tracer was injected into the dermis around the site of the primary melanoma. Forty-four patients also had blue dye injected immediately prior to surgical resection. Measurement of radioactivity in the lymph nodes and surgical localization were made using a handheld gamma detector. Radiolabeled nodes were selectively removed with the least dissection possible. In patients with pathologically positive radiolabeled nodes, regional lymphadenectomy was performed. Successful identification of radiolabeled sentinel lymph nodes, correlation of radiolabeling with injection of blue dye, and regional node recurrence rate. Surgeons successfully resected the radiolabeled sentinel lymph nodes in 118 (98%) of 121 patients. One hundred percent of blue-stained lymph nodes were successfully radiolabeled. Fifteen patients had pathologically positive sentinel lymph nodes. In 10 patients, the sentinel node was the only node with metastasis. Two systemic and one regional node recurrences occurred during a mean follow-up of 220 days. Selective gamma probe—guided resection of the radiolabeled sentinel lymph node is possible in over 95% of patients with melanoma. This technique offers a simple and reliable method of staging of regional lymph nodes in these patients without performing a regional lymphadenectomy.

Original languageEnglish
Pages (from-to)654-658
Number of pages5
JournalArchives of Surgery
Volume130
Issue number6
DOIs
StatePublished - 1995
Externally publishedYes

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Melanoma
Lymph Nodes
Lymph Node Excision
Coloring Agents
Clinical Trials
Radioactive Tracers
Neoplasm Metastasis
Recurrence
Private Practice
Tertiary Healthcare
Dermis
Teaching Hospitals
Radioactivity
Dissection
Injections
Sentinel Lymph Node

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Krag, D. N., Meijer, S. J., Weaver, D. L., Loggie, B. W., Harlow, S. P., Tanabe, K. K., ... Alex, J. C. (1995). Minimal-Access Surgery for Staging of Malignant Melanoma. Archives of Surgery, 130(6), 654-658. https://doi.org/10.1001/archsurg.1995.01430060092018

Minimal-Access Surgery for Staging of Malignant Melanoma. / Krag, David N.; Meijer, Sybren J.; Weaver, Donald L.; Loggie, Brian W.; Harlow, Seth P.; Tanabe, Kenneth K.; Laughlin, Edward H.; Alex, James C.

In: Archives of Surgery, Vol. 130, No. 6, 1995, p. 654-658.

Research output: Contribution to journalArticle

Krag, DN, Meijer, SJ, Weaver, DL, Loggie, BW, Harlow, SP, Tanabe, KK, Laughlin, EH & Alex, JC 1995, 'Minimal-Access Surgery for Staging of Malignant Melanoma', Archives of Surgery, vol. 130, no. 6, pp. 654-658. https://doi.org/10.1001/archsurg.1995.01430060092018
Krag, David N. ; Meijer, Sybren J. ; Weaver, Donald L. ; Loggie, Brian W. ; Harlow, Seth P. ; Tanabe, Kenneth K. ; Laughlin, Edward H. ; Alex, James C. / Minimal-Access Surgery for Staging of Malignant Melanoma. In: Archives of Surgery. 1995 ; Vol. 130, No. 6. pp. 654-658.
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