Recorrência em pacientes portadores de melanoma cutâneo submetidos a biópsia de linfonodo sentinela: seguimento mediano de 37 meses

• Autor(a) principal: Oliveira Filho, Renato Santos de [UNIFESP]
• Data de Publicação: 2004
• Outros Autores: Silva, Allisson Monteiro da [UNIFESP], Arcuschin, Liliana, Wagner, Jairo, Yamaga, Lilian Yuri
• 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
• topic: Sentinel node biopsy; Cutaneous melanoma; Lymphoscintigraphy; Lymphatic mapping; Biópsia de Linfonodo Sentinela; Melanoma cutâneo; Linfocintilografia; Mapeamento linfático

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.