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    Is skipped nodal metastasis a phenomenon of cutaneous melanoma?

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    Authors
    El-Omar, Omar
    Ragavan, Sharanniyan
    Yoon, Won Young
    Grant, Megan E
    Green, Adèle C
    Oudit, Deemesh
    Affiliation
    The Christie NHS Foundation Trust, Wilmslow Rd, Manchester,
    Issue Date
    2021
    
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    Abstract
    Background and methods: Skipped nodal metastasis (SNM) is a recognized phenomenon of visceral cancers when metastases bypass the regional basin and skip to a distant nodal basin without evidence of distant metastases. Its occurrence is undocumented in cutaneous melanoma patients but of potential prognostic significance. We therefore assessed the frequency of SNM in a large series of patients with limb melanomas. Patients and methods: We studied melanoma patients attending a tertiary oncology hospital in northwest England using two approaches. First, we systematically searched medical records of an unselected patient sample treated 2002-2015, and second, we studied lymphoscintigrams of all patients with limb melanoma who underwent sentinel node biopsy 2008-2019. Results: Of 672 melanoma patients whose clinical records were examined, 16 had regional nodal metastases without apparent visceral spread and one appeared to have SNM but further scans were uncovered that showed concurrent pulmonary metastases. Of 667 limb melanoma patients with lymphoscintigrams, 7 showed dual lymphatic drainage patterns to distal as well as regional nodal basins, but none had micro-metastases solely in the distant basin. Conclusion: Occurrence of SNM in cutaneous melanoma is highly unlikely.
    Citation
    El-Omar O, Ragavan S, Yoon WY, Grant ME, Green AC, Oudit D. Is skipped nodal metastasis a phenomenon of cutaneous melanoma? Vol. 29, Cancer Treatment and Research Communications. Elsevier BV; 2021. p. 100485.
    Journal
    Cancer Treatment and Research Communications
    URI
    http://hdl.handle.net/10541/624937
    DOI
    10.1016/j.ctarc.2021.100485
    PubMed ID
    34798594
    Type
    Article
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ctarc.2021.100485
    Scopus Count
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