Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S0100-69912004000500002 http://repositorio.unifesp.br/handle/11600/2247 |
Resumo: | BACKGROUND: Sentinel node biopsy (SNB) has been considered as an advance in surgical oncology for microstading melanoma. We report our experience with this procedure focusing on recurrence. METHODS: SNB was performed in 133 cutaneous melanoma patients submitted to preoperative lymphoscintigraphy, lymphatic mapping and gamma probe detection. Histologycal samples were analysed by HE and immunohistochemistry (IHC). RESULTS: The sentinel node was detected in 126 patients (96.2%). Micrometastasis were diagnosed in 20 patients (15.6%). There were nine recurrence, four in negative sentinel node group (108 patients). In this group, there was one systemic recurrence and three (2.8%) on lymphatic drainage region (false negative). In positive sentinel node group (20 patients) there were five recurrences. The recurrence was lower among negative sentinel node patients (p=0.0048). Ulceration (p=0.029) and positivity of the sentinel node (p=0.003) were considered significant risk factor by logistic analisys. Only sentinel node positivity maintained significance on multivariate analysis (p=0.024). The median follow up was 37 months. CONCLUSION: Patients with positive sentinel node presented more recurrence than negative sentinel node patients. The false negative rate was 2.8% and patients didn't have long-term sequelae ,allowing us to consider SNB as a secure and accurate procedure for melanoma staging. |
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Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 mesesPatterns of recurrence following sentinel lymph node biopsy for cutaneous melanoma: outcome after 37 months of follow-upSentinel node biopsyCutaneous melanomaLymphoscintigraphyLymphatic mappingBiópsia de Linfonodo SentinelaMelanoma cutâneoLinfocintilografiaMapeamento linfáticoBACKGROUND: Sentinel node biopsy (SNB) has been considered as an advance in surgical oncology for microstading melanoma. We report our experience with this procedure focusing on recurrence. METHODS: SNB was performed in 133 cutaneous melanoma patients submitted to preoperative lymphoscintigraphy, lymphatic mapping and gamma probe detection. Histologycal samples were analysed by HE and immunohistochemistry (IHC). RESULTS: The sentinel node was detected in 126 patients (96.2%). Micrometastasis were diagnosed in 20 patients (15.6%). There were nine recurrence, four in negative sentinel node group (108 patients). In this group, there was one systemic recurrence and three (2.8%) on lymphatic drainage region (false negative). In positive sentinel node group (20 patients) there were five recurrences. The recurrence was lower among negative sentinel node patients (p=0.0048). Ulceration (p=0.029) and positivity of the sentinel node (p=0.003) were considered significant risk factor by logistic analisys. Only sentinel node positivity maintained significance on multivariate analysis (p=0.024). The median follow up was 37 months. CONCLUSION: Patients with positive sentinel node presented more recurrence than negative sentinel node patients. The false negative rate was 2.8% and patients didn't have long-term sequelae ,allowing us to consider SNB as a secure and accurate procedure for melanoma staging.OBJETIVO: A biópsia de linfonodo sentinela (BLS) representa um avanço na cirurgia oncológica para o microestadiamento do melanoma. Apresentamos nossa experiência dando ênfase para a recorrência. MÉTODO: A BLS foi realizada em 133 pacientes portadores de melanoma cutâneo localizado envolvendo linfocintilografia, mapeamento linfático e detecção gama intra-operatórios em todos os pacientes. O exame histopatológico foi realizado por HE e imunohistoquímica (IHC). RESULTADOS: Encontrou-se LS em 128 pacientes (96,2%). Micrometástase foi diagnosticada em 20 pacientes (15,6%). Houve nove recorrências, sendo quatro no grupo com LS negativo (108 pacientes). Neste grupo, houve uma recorrência sistêmica e três (2,8%) na região linfática de drenagem (falso negativo). No grupo com LS positivo (20 pacientes) ocorreram cinco recorrências. Houve diferença significativa de recorrência entre os grupos, tendo sido menor no grupo LS negativo (p=0,0048). Através de análise de regressão logística univariada a ulceração (p=0,029) e a positividade do LS (p=0,003) apresentaram significância estatística como fatores de risco. Porém, apenas a positividade do LS manteve singificância na análise multivariada (p=0,024). O seguimento mediano foi de 37 meses. CONCLUSÕES: Pacientes com LS positivo apresentam recorrência significativamente maior que pacientes com LS negativo. O índice de falso negativo foi de 2,8% e os pacientes não apresentaram seqüelas o que permite considerar a BLS como procedimento seguro para o microestadiamento do melanoma cutâneo.UNIFESP-EPMCentro Avançado de Prevenção e Tratamento de CâncerHospital Israelita Albert EinsteinUniversidade de São PauloUNIFESP, EPMSciELOColégio Brasileiro de CirurgiõesUniversidade Federal de São Paulo (UNIFESP)Centro Avançado de Prevenção e Tratamento de CâncerHospital Israelita Albert EinsteinUniversidade de São Paulo (USP)Oliveira Filho, Renato Santos de [UNIFESP]Silva, Allisson Monteiro da [UNIFESP]Arcuschin, LilianaWagner, JairoYamaga, Lilian Yuri2015-06-14T13:31:18Z2015-06-14T13:31:18Z2004-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion279-283application/pdfhttp://dx.doi.org/10.1590/S0100-69912004000500002Revista do Colégio Brasileiro de Cirurgiões. Colégio Brasileiro de Cirurgiões, v. 31, n. 5, p. 279-283, 2004.10.1590/S0100-69912004000500002S0100-69912004000500002.pdf0100-6991S0100-69912004000500002http://repositorio.unifesp.br/handle/11600/2247porRevista do Colégio Brasileiro de Cirurgiõesinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-05T21:47:42Zoai:repositorio.unifesp.br/:11600/2247Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-05T21:47:42Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses Patterns of recurrence following sentinel lymph node biopsy for cutaneous melanoma: outcome after 37 months of follow-up |
title |
Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses |
spellingShingle |
Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses Oliveira Filho, Renato Santos de [UNIFESP] Sentinel node biopsy Cutaneous melanoma Lymphoscintigraphy Lymphatic mapping Biópsia de Linfonodo Sentinela Melanoma cutâneo Linfocintilografia Mapeamento linfático |
title_short |
Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses |
title_full |
Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses |
title_fullStr |
Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses |
title_full_unstemmed |
Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses |
title_sort |
Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses |
author |
Oliveira Filho, Renato Santos de [UNIFESP] |
author_facet |
Oliveira Filho, Renato Santos de [UNIFESP] Silva, Allisson Monteiro da [UNIFESP] Arcuschin, Liliana Wagner, Jairo Yamaga, Lilian Yuri |
author_role |
author |
author2 |
Silva, Allisson Monteiro da [UNIFESP] Arcuschin, Liliana Wagner, Jairo Yamaga, Lilian Yuri |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Centro Avançado de Prevenção e Tratamento de Câncer Hospital Israelita Albert Einstein Universidade de São Paulo (USP) |
dc.contributor.author.fl_str_mv |
Oliveira Filho, Renato Santos de [UNIFESP] Silva, Allisson Monteiro da [UNIFESP] Arcuschin, Liliana Wagner, Jairo Yamaga, Lilian Yuri |
dc.subject.por.fl_str_mv |
Sentinel node biopsy Cutaneous melanoma Lymphoscintigraphy Lymphatic mapping Biópsia de Linfonodo Sentinela Melanoma cutâneo Linfocintilografia Mapeamento linfático |
topic |
Sentinel node biopsy Cutaneous melanoma Lymphoscintigraphy Lymphatic mapping Biópsia de Linfonodo Sentinela Melanoma cutâneo Linfocintilografia Mapeamento linfático |
description |
BACKGROUND: Sentinel node biopsy (SNB) has been considered as an advance in surgical oncology for microstading melanoma. We report our experience with this procedure focusing on recurrence. METHODS: SNB was performed in 133 cutaneous melanoma patients submitted to preoperative lymphoscintigraphy, lymphatic mapping and gamma probe detection. Histologycal samples were analysed by HE and immunohistochemistry (IHC). RESULTS: The sentinel node was detected in 126 patients (96.2%). Micrometastasis were diagnosed in 20 patients (15.6%). There were nine recurrence, four in negative sentinel node group (108 patients). In this group, there was one systemic recurrence and three (2.8%) on lymphatic drainage region (false negative). In positive sentinel node group (20 patients) there were five recurrences. The recurrence was lower among negative sentinel node patients (p=0.0048). Ulceration (p=0.029) and positivity of the sentinel node (p=0.003) were considered significant risk factor by logistic analisys. Only sentinel node positivity maintained significance on multivariate analysis (p=0.024). The median follow up was 37 months. CONCLUSION: Patients with positive sentinel node presented more recurrence than negative sentinel node patients. The false negative rate was 2.8% and patients didn't have long-term sequelae ,allowing us to consider SNB as a secure and accurate procedure for melanoma staging. |
publishDate |
2004 |
dc.date.none.fl_str_mv |
2004-10-01 2015-06-14T13:31:18Z 2015-06-14T13:31:18Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0100-69912004000500002 Revista do Colégio Brasileiro de Cirurgiões. Colégio Brasileiro de Cirurgiões, v. 31, n. 5, p. 279-283, 2004. 10.1590/S0100-69912004000500002 S0100-69912004000500002.pdf 0100-6991 S0100-69912004000500002 http://repositorio.unifesp.br/handle/11600/2247 |
url |
http://dx.doi.org/10.1590/S0100-69912004000500002 http://repositorio.unifesp.br/handle/11600/2247 |
identifier_str_mv |
Revista do Colégio Brasileiro de Cirurgiões. Colégio Brasileiro de Cirurgiões, v. 31, n. 5, p. 279-283, 2004. 10.1590/S0100-69912004000500002 S0100-69912004000500002.pdf 0100-6991 S0100-69912004000500002 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
279-283 application/pdf |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268403620249600 |