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2018, Number 6

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Gac Med Mex 2018; 154 (6)

Melanoma cutáneo. Etapificación ganglionar con base en la evidencia actual

Gallegos-Hernández JF
Full text How to cite this article

Language: Spanish
References: 6
Page: 712-715
PDF size: 124.47 Kb.


Key words:

Cutaneous melanoma, Sentinel lymph node, Lymphadenectomy, Lymph nodes.

ABSTRACT

Most patients with cutaneous melanoma present with clinical stage 1 at diagnosis, i.e., with no evidence of lymph node or systemic metastases. However, since this is a type of neoplasm with high affinity to lymphatic tissue, between 30 and 60% of patients are estimated to have occult metastases on the lymph nodes of the area that drains the primary tumor site at the moment of diagnosis. This possibility depends on several histologic factors, especially thickness of the neoplasm. Historically, in order to reduce the rate of regional recurrence, lymphadenectomy was an essential part of cutaneous melanoma treatment, which has associated morbidity. In the decade of 1990, Morton et al. reported that lymph is initially received by a single lymph node in the lymphatic basin and that its histological status predicts the status of the others and that, therefore, in patients with sentinel lymph node free of metastases lymphadenectomy is not necessary, which reduces morbidity. In the present manuscript, indications, contraindications and requirements for sentinel lymph node identification are described, as well as its current value in cutaneous melanoma diagnostic and therapeutic process.


REFERENCES

  1. Gallegos JF ¿Qué es el ganglio centinela? Concepto y aplicaciones en oncología. Acta Med Grupo Angeles. 2005;3:91-98.

  2. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FJ, et al Technical details of intraoperative lymphatic zapping for early stage melanoma. Arch Surg. 1992;127:392-399.

  3. Nieweg OE, Uren RF, Thompson JF. The history of sentinel node biopsy. Cancer J. 2015;21:3-6.

  4. Morton DL, Thompson JF, Cochran AJ, Mozillo N, Nieweg OE, Roses DF, et al. Final trial report of sentinel-node biopsy vs nodal observation in melanoma. N Engl J Med. 2014;370 599-609.

  5. Balch CM, Thompson JF, Gershenwald JE. Age as a predictor od sentinel node metastasis among patients with localized melanoma: an inverse correlation of melanoma mortality and incidence of sentinel node metastasis among young and old patients. Ann Surg Oncol. 2014;21:1075-1081.

  6. Faries MB, Thompson JF, Cochran AJ, Andbacka RH, Mozillo N, Zager JS, et al. Completion dissection or observation for sentinel-node metastasis in melanoma. N Engl J Med. 2017;376:2211-2222.




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Gac Med Mex. 2018;154