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Abstract
Introduction. Early diagnosis and effective treatment of skin melanoma is very important because its incidence is steadily increasing. The mortality rate of this malignant tumor is significantly higher than that of other skin cancers. A sentinel lymph node biopsy as a confirmatory diagnosis can lead to an individualised prognosis of the disease and a change in the stage of the tumour with the prescription of effective adjuvant targeting or immunotherapy, increasing the likelihood of a complete cure for these patients.
Materials and Methods. The present article analyses the data of sentinel lymph node biopsy using the ICG fluorescence method for localized cutaneous melanoma in the clinical practice of the Botkin Hospital. We analyzed data from 54 patients with localized stages of melanoma of the trunk and extremities (Ib-IIC stages, ECOG 0-1) who underwent surgery: skin tumor excision with sentinel lymph node biopsy (SLNB) using the fluorescence method with indocyanine green (ICG). The post-operative course was further evaluated and follow-up examinations were performed at 3 and 6 months to exclude loco-regional recurrence.
Results. According to frozen section pathology data, micrometastases were detected in 3 (6 %) patients, and according to routine IHC data, lymph nodes were «positive» in 8 (15 %) patients. 43 patients (79 %) had no micro- or macrometastatic lymph node involvement (pN0). No post-operative complications were observed in any of the patients and no allergic reactions were noted. At follow-up, there was no evidence of locoregional recurrence in the pN0 group. Three patients with progression at follow-up were in the positive sentinel lymph node group.
Conclusion. Based on our experience, the fluorescent technique using indocyanine green (ICG) to detect the sentinel lymph node(s) in localised melanoma of the trunk and extremities is safe and highly effective. This technique allows accurate, and most importantly, timely staging of skin melanoma and selection of optimal and personalized tactics for further treatment and follow-up.
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