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Dilemma of clinically node‐negative head and neck melanoma: Outcome of “watch and wait” policy, elective lymph node dissection, and sentinel node biopsy—A systematic review
Author(s) -
Tanis Pieter J.,
Nieweg Omgo E.,
van den Brekel Michiel W. M.,
Balm Alfons J. M.
Publication year - 2008
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20749
Subject(s) - medicine , sentinel node , melanoma , sentinel lymph node , biopsy , randomized controlled trial , neck dissection , lymph node , surgery , dissection (medical) , radiology , general surgery , cancer , breast cancer , cancer research
Abstract Background The management of patients with clinically node‐negative melanoma of the head and neck remains controversial. Methods This is a systematic review of management strategies for stage I head and neck melanoma. Results Subgroup analysis of 1 randomized controlled trial (RCT) and most available cohort studies do not reveal a significant impact of elective neck dissection on survival. For 1.2‐ to 3.5‐mm‐thick melanoma at all anatomical sites, 1 RCT does not show an overall significant melanoma‐specific survival benefit of sentinel node biopsy, but subgroup analysis suggests a survival benefit for lymph node–positive patients, confirming findings from 3 retrospective series. Sentinel node biopsy in the head and neck region can be technically demanding, with lower identification rates and higher false‐negative rates. Conclusion There is no conclusive survival advantage of either elective neck dissection or sentinel node biopsy in patients with clinically node‐negative head and neck melanoma of intermediate thickness. © 2008 Wiley Periodicals, Inc. Head Neck, 2008