{'fraction_non_alphanumeric': 0.061052631578947365, 'fraction_numerical': 0.03747368421052632, 'mean_word_length': 4.387755102040816, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 1, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Sentinel lymphadenectomy guided complete lymph node dissection improves loco-regional disease control in early-stage head and neck melanoma.

7552 Introduction: The utility of lymphatic mapping (LM) and sentinel lymphadenectomy (SL) in head and neck (H&N) melanoma is still debated. The purpose of this study is to determine the therapeutic efficacy of LM/SL-directed surgical clearance of tumor-involved lymph node (LN) basins in early-stage cutaneous H&N melanoma.


METHODS
Database query identified all cutaneous H&N melanoma patients who were seen at our institution within first 3 months of diagnosis and underwent surgery between 1974 - 2002. Inclusion criteria were stage I - III, wide local excision (WLE) only, WLE/SL ± complete lymph node dissection (CLND), and at least 1-year of follow-up. Exclusion criteria were mucosal melanoma and stage III with palpable LNs. Group 1 underwent WLE only, whereas Group 2 underwent WLE/SL + CLND if sentinel node contained metastatic tumor. Patients from each group were matched for Breslow thickness (0 - 1 mm, 1.01 - 2 mm, 2.01 - 3 mm, 3.01 - 4 mm, > 4 mm), primary site (face/nose, scalp, ear, neck), and gender. 5-year disease free survival (DFS), loco-regional recurrence (LRR), and times to LRR were measured. χ2 and log-rank tests were used to determine statistical significance.


RESULTS
Of 604 eligible patients, 176 patients from each group (total of 352) were matched for above prognostic factors. Distribution of Clark level (p = 0.16) and % of patients with ulceration (p = 0.63) were not different. 5-year DFS rates were not statistically different (65 ± 4% for Group 1 vs. 71 ± 4 for Group 2; p = 0.287). However, the difference in LRR was statistically significant (Group 1: 20% vs. Group 2: 6.3%; p = 0.0001). Despite differences in median follow-up times (99 vs. 51 months), the median/mean times to LRR were not different (Group 1: 12/26 months vs. Group 2: 13/36 months; p = 0.56).


CONCLUSIONS
Our data indicate that LM/SL-directed surgical clearance of melanoma-involved LN basins decreases the incidence of LRR for early-stage cutaneous H&N melanoma. Its therapeutic superiority in controlling loco-regional disease, when compared to WLE alone, provides a de-facto evidence of validity for application of LM/SL in early-stage cutaneous H&N melanoma. No significant financial relationships to disclose.