Reliability of sentinel lymph-node extirpation as a diagnostic method for malignant melanoma of the head and neck region

A series of 106 patients with malignant melanoma of the head and neck and clinically negative local lymph-node status were included in a multimodal therapy programme and underwent sentinel lymph-node extirpation in 1999–2003. Out of 246 preoperatively marked lymph nodes, only 172 (70%) were identified intraoperatively and removed. In 89% of all patients at least one sentinel lymph node was removed. Histological examination revealed metastases in the sentinel lymph nodes of 17 patients. In the mean follow-up period of 47 months (range 4–76 months), regional lymph-node metastases were found in another eight patients. The non-marked lymph nodes that were often removed at the same time, in an elective cervical lymph-node dissection, did not reveal any metastasis in any of the cases where the sentinel lymph nodes were negative. The sensitivity of sentinel lymph-node extirpation was influenced by the length of the follow-up period and the detection rate, and was 68% (17/17 + 8), a result superior to that of any other diagnostic tool. Sentinel lymph-node extirpation is a valuable method in addition to elective lymph-node dissection.