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Parotid Region Lymphatic Mapping and Sentinel Lymphadenectomy for Cutaneous Melanoma

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Abstract

Background: Routine elective superficial parotidectomy for patients with primary cutaneous melanomas of the scalp, auricle, or face has been questioned. We evaluated an alternative, i.e., lymphatic mapping and sentinel lymphadenectomy, for patients with primary cutaneous melanomas draining to the region of the parotid gland.

Patients: Retrospective review of our large >.8000 patients) melanoma database identified 39 patients with primary melanomas (American Joint Committee on Cancer stage I or II) of the scalp (n = 19), auricle (n = 11), or face (n = 9) who underwent intraoperative lymphatic mapping to identify a sentinel node (SN) in the region of the parotid gland, between June 1985 and July 1997.

Results: A SN was identified in the parotid region of 37 patients (94.9%), four of whom had SN metastases. The mean number of SN obtained was 2.3/patient (range, 1–4/patient). The two patients (5.1%) for whom a parotid-region SN could not be identified underwent superficial parotidectomy during the same operation. Among the 33 patients with tumor-free SN, with a median follow-up period of 33.2 months (range, 1-121 months), there was one (3.1%) intraparotid recurrence; thus, the false-negative rate was 3.1%. The procedure-related surgical morbidity rate was only 2.6% (one case of temporary facial nerve paresis).

Conclusions: For patients with primary melanomas of the scalp, auricle, or face, sentinel lymphadenectomy can be performed accurately in the parotid region and offers a low-morbidity alternative to routine elective superficial parotidectomy.

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Author notes

  1. David W. Ollila MD

    Present address: University of North Carolina, Chapel Hill, North Carolina

Authors and Affiliations

  1. Roy E. Coats Research Laboratories of the John Wayne Cancer Institute, St. John’s Health Center, Santa Monica, California

    David W. Ollila MD, Leland J. Foshag MD, Richard Essner MD, Stacey L. Stern MS & Donald L. Morton MD

  2. John Wayne Cancer Institute, 2200 Santa Monica Blvd., Santa Monica, CA, 90404

    Donald L. Morton MD

Authors
  1. David W. Ollila MD
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  2. Leland J. Foshag MD
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  3. Richard Essner MD
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  4. Stacey L. Stern MS
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  5. Donald L. Morton MD
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Additional information

Supported by Grants CA12562 and CA29605 from the National Cancer Institute and by funding from the Wrather Family Foundation (Los Angeles, CA).

Presented at the 51st Annual Cancer Symposium of The Society of Surgical Oncology, San Diego, California, March 26-29, 1998.

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Ollila, D.W., Foshag, L.J., Essner, R. et al. Parotid Region Lymphatic Mapping and Sentinel Lymphadenectomy for Cutaneous Melanoma. Ann Surg Oncol 6, 150–154 (1999). https://doi.org/10.1007/s10434-999-0150-0

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  • DOI: https://doi.org/10.1007/s10434-999-0150-0

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