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Routine biopsy of cloquet's node is of limited value in sentinel node positive melanoma patients
Author(s) -
Chu Carrie K.,
Zager Jonathan S.,
Marzban Suroosh S.,
Gimbel Mark I.,
Murray Douglas R.,
Hestley Andrea C.,
Messina Jane L.,
Sondak Ver K.,
Carlson Grant W.,
Delman Keith A.
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21635
Subject(s) - medicine , dissection (medical) , groin , sentinel node , biopsy , surgery , radiology , concomitant , cancer , breast cancer
Background and Objectives Biopsy of Cloquet's node (CN) during groin dissection has been used to indicate need for pelvic dissection. With earlier detection of microscopic regional disease in the era of sentinel node biopsy (SNB), frequency of positive CN may be so low that routine biopsy is unwarranted. Methods Patients with positive groin SNB from 2000 to 2008 were identified from two centers. Cases where CN was identified at completion node dissection were selected. Lymphoscintigraphic, surgical, pathologic, and recurrence data were reviewed. Results CN was identified in 53 cases. Median age was 44.5 years (range 7–77); median Breslow depth, 1.98 mm (range 0.5–25.0); % Clark's level IV/V, 90%; and % ulceration, 41.5%. Fifty (94.3%) underwent groin dissection alone; three others underwent concomitant pelvic dissection. Two (3.8%) patients had positive CN; both had additional indications for pelvic dissection. Delayed pelvic recurrence rate was 2/53 (3.8%); both patients had negative CN. In the three patients treated with concurrent groin and pelvic dissection, CN reflected pelvic nodal status in two cases; the third had pelvic metastases despite negative CN. Conclusions After positive SNB, disease involvement of CN is rare. Patients with positive biopsies of CN in the SNB era appear likely to have additional indications for pelvic dissection, minimizing utility of CN biopsy. Routine intraoperative sampling of CN may not be warranted during groin dissection for positive SNB. J. Surg. Oncol. 2010;102:315–320. © 2010 Wiley‐Liss, Inc.