Prognostic Significance and Management of Sentinel Nodes in the Triangular Intermuscular Space of Patients with Melanoma

Trine Schoenfeldt; John F. Thompson; Serigne Lo; Krzysztof T. Drzewiecki; Jonathan Stretch; Robyn P.M. Saw; Andrew Spillane; Kerwin Shannon; Roger F. Uren; Annette H. Chakera; Omgo E. Nieweg

doi:10.1245/s10434-022-12840-2

Prognostic Significance and Management of Sentinel Nodes in the Triangular Intermuscular Space of Patients with Melanoma

Trine Schoenfeldt, John F. Thompson^*, Serigne Lo, Krzysztof T. Drzewiecki, Jonathan Stretch, Robyn P.M. Saw, Andrew Spillane, Kerwin Shannon, Roger F. Uren, Annette H. Chakera, Omgo E. Nieweg

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

2 Citationer (Scopus)

Abstract

Background: The clinical significance of sentinel nodes (SNs) in the triangular intermuscular space (TIS) of patients with melanoma is poorly understood. This study aimed to determine their incidence and positivity rate, and to report their management and patient outcomes. Methods: This was a single-institution retrospective cohort study of patients with unilateral or bilateral TIS SNs on lymphoscintigraphy treated between 1992 and 2017. Recurrence-free survival was analyzed. Results: Lymphoscintigraphy identified TIS SNs in 266 patients. They were bilateral in 17 patients. Of the 2296 patients with a melanoma on the upper back, 259 (11%) had TIS SNs. Procurement of SNs was not attempted in 122 (43%) of the 283 cases and failed in 11 cases (7%). An SN was successfully retrieved from the TIS in 145 patients (53%) and contained metastasis in 18 of 150 TIS SNs. This was the only positive SN in 12 patients (8%), upstaging all of them. Of the 18 patients with a positive SN in the TIS, 9 (50%) underwent completion axillary lymph node dissection, but no additional involved nodes were found in any of these patients. Recurrence in the TIS was observed in six patients (5%), none of whom had their TIS SN surgically pursued previously. Conclusions: Lymphoscintigraphy showed TIS SNs in 11% of patients with melanomas on their upper back. In such cases, retrieval of TIS SNs is required for accurate staging and to minimize the risk of TIS recurrence.

Originalsprog	Engelsk
Tidsskrift	Annals of Surgical Oncology
Vol/bind	30
Sider (fra-til)	2354–2361
ISSN	1068-9265
DOI	https://doi.org/10.1245/s10434-022-12840-2
Status	Udgivet - 2023

Bibliografisk note

Funding Information:
This study was funded by the Danish Cancer Society, Reinholdt W. Jorck og Hustrus Fond, and Knud Højgaard Fonden. We thank Melanoma Institute Australia and Alfred Nuclear Medicine and Ultrasound, Sydney, Australia for facilitating this study by providing staff assistance and resources. Special thanks go to Hazel Bourke, who undertook data extraction from the institutional database and to Kaye Oakley, Martin Drummond, and Kim Ioannou for their assistance.

Publisher Copyright:
© 2022, Society of Surgical Oncology.

Adgang til dokumentet

10.1245/s10434-022-12840-2

Citationsformater

Schoenfeldt, T., Thompson, J. F., Lo, S., Drzewiecki, K. T., Stretch, J., Saw, R. P. M., Spillane, A., Shannon, K., Uren, R. F., Chakera, A. H., & Nieweg, O. E. (2023). Prognostic Significance and Management of Sentinel Nodes in the Triangular Intermuscular Space of Patients with Melanoma. Annals of Surgical Oncology, 30, 2354–2361. https://doi.org/10.1245/s10434-022-12840-2

Prognostic Significance and Management of Sentinel Nodes in the Triangular Intermuscular Space of Patients with Melanoma. / Schoenfeldt, Trine; Thompson, John F.; Lo, Serigne; Drzewiecki, Krzysztof T.; Stretch, Jonathan; Saw, Robyn P.M.; Spillane, Andrew; Shannon, Kerwin; Uren, Roger F.; Chakera, Annette H.; Nieweg, Omgo E.

I: Annals of Surgical Oncology, Bind 30, 2023, s. 2354–2361.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Schoenfeldt, Trine ; Thompson, John F. ; Lo, Serigne ; Drzewiecki, Krzysztof T. ; Stretch, Jonathan ; Saw, Robyn P.M. ; Spillane, Andrew ; Shannon, Kerwin ; Uren, Roger F. ; Chakera, Annette H. ; Nieweg, Omgo E. / Prognostic Significance and Management of Sentinel Nodes in the Triangular Intermuscular Space of Patients with Melanoma. I: Annals of Surgical Oncology. 2023 ; Bind 30. s. 2354–2361.

@article{ec5c967741ec48178ed581dcc21b40b1,

title = "Prognostic Significance and Management of Sentinel Nodes in the Triangular Intermuscular Space of Patients with Melanoma",

abstract = "Background: The clinical significance of sentinel nodes (SNs) in the triangular intermuscular space (TIS) of patients with melanoma is poorly understood. This study aimed to determine their incidence and positivity rate, and to report their management and patient outcomes. Methods: This was a single-institution retrospective cohort study of patients with unilateral or bilateral TIS SNs on lymphoscintigraphy treated between 1992 and 2017. Recurrence-free survival was analyzed. Results: Lymphoscintigraphy identified TIS SNs in 266 patients. They were bilateral in 17 patients. Of the 2296 patients with a melanoma on the upper back, 259 (11%) had TIS SNs. Procurement of SNs was not attempted in 122 (43%) of the 283 cases and failed in 11 cases (7%). An SN was successfully retrieved from the TIS in 145 patients (53%) and contained metastasis in 18 of 150 TIS SNs. This was the only positive SN in 12 patients (8%), upstaging all of them. Of the 18 patients with a positive SN in the TIS, 9 (50%) underwent completion axillary lymph node dissection, but no additional involved nodes were found in any of these patients. Recurrence in the TIS was observed in six patients (5%), none of whom had their TIS SN surgically pursued previously. Conclusions: Lymphoscintigraphy showed TIS SNs in 11% of patients with melanomas on their upper back. In such cases, retrieval of TIS SNs is required for accurate staging and to minimize the risk of TIS recurrence.",

author = "Trine Schoenfeldt and Thompson, {John F.} and Serigne Lo and Drzewiecki, {Krzysztof T.} and Jonathan Stretch and Saw, {Robyn P.M.} and Andrew Spillane and Kerwin Shannon and Uren, {Roger F.} and Chakera, {Annette H.} and Nieweg, {Omgo E.}",

note = "Publisher Copyright: {\textcopyright} 2022, Society of Surgical Oncology.",

year = "2023",

doi = "10.1245/s10434-022-12840-2",

language = "English",

volume = "30",

pages = "2354–2361",

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issn = "1068-9265",

publisher = "Springer",

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TY - JOUR

T1 - Prognostic Significance and Management of Sentinel Nodes in the Triangular Intermuscular Space of Patients with Melanoma

AU - Schoenfeldt, Trine

AU - Thompson, John F.

AU - Lo, Serigne

AU - Drzewiecki, Krzysztof T.

AU - Stretch, Jonathan

AU - Saw, Robyn P.M.

AU - Spillane, Andrew

AU - Shannon, Kerwin

AU - Uren, Roger F.

AU - Chakera, Annette H.

AU - Nieweg, Omgo E.

PY - 2023

Y1 - 2023

N2 - Background: The clinical significance of sentinel nodes (SNs) in the triangular intermuscular space (TIS) of patients with melanoma is poorly understood. This study aimed to determine their incidence and positivity rate, and to report their management and patient outcomes. Methods: This was a single-institution retrospective cohort study of patients with unilateral or bilateral TIS SNs on lymphoscintigraphy treated between 1992 and 2017. Recurrence-free survival was analyzed. Results: Lymphoscintigraphy identified TIS SNs in 266 patients. They were bilateral in 17 patients. Of the 2296 patients with a melanoma on the upper back, 259 (11%) had TIS SNs. Procurement of SNs was not attempted in 122 (43%) of the 283 cases and failed in 11 cases (7%). An SN was successfully retrieved from the TIS in 145 patients (53%) and contained metastasis in 18 of 150 TIS SNs. This was the only positive SN in 12 patients (8%), upstaging all of them. Of the 18 patients with a positive SN in the TIS, 9 (50%) underwent completion axillary lymph node dissection, but no additional involved nodes were found in any of these patients. Recurrence in the TIS was observed in six patients (5%), none of whom had their TIS SN surgically pursued previously. Conclusions: Lymphoscintigraphy showed TIS SNs in 11% of patients with melanomas on their upper back. In such cases, retrieval of TIS SNs is required for accurate staging and to minimize the risk of TIS recurrence.

AB - Background: The clinical significance of sentinel nodes (SNs) in the triangular intermuscular space (TIS) of patients with melanoma is poorly understood. This study aimed to determine their incidence and positivity rate, and to report their management and patient outcomes. Methods: This was a single-institution retrospective cohort study of patients with unilateral or bilateral TIS SNs on lymphoscintigraphy treated between 1992 and 2017. Recurrence-free survival was analyzed. Results: Lymphoscintigraphy identified TIS SNs in 266 patients. They were bilateral in 17 patients. Of the 2296 patients with a melanoma on the upper back, 259 (11%) had TIS SNs. Procurement of SNs was not attempted in 122 (43%) of the 283 cases and failed in 11 cases (7%). An SN was successfully retrieved from the TIS in 145 patients (53%) and contained metastasis in 18 of 150 TIS SNs. This was the only positive SN in 12 patients (8%), upstaging all of them. Of the 18 patients with a positive SN in the TIS, 9 (50%) underwent completion axillary lymph node dissection, but no additional involved nodes were found in any of these patients. Recurrence in the TIS was observed in six patients (5%), none of whom had their TIS SN surgically pursued previously. Conclusions: Lymphoscintigraphy showed TIS SNs in 11% of patients with melanomas on their upper back. In such cases, retrieval of TIS SNs is required for accurate staging and to minimize the risk of TIS recurrence.

U2 - 10.1245/s10434-022-12840-2

DO - 10.1245/s10434-022-12840-2

M3 - Journal article

C2 - 36463358

AN - SCOPUS:85143228872

VL - 30

SP - 2354

EP - 2361

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

ER -