2018-19 Section 7-Neoplastic and Inflammatory Diseases of the Head and Neck eBook

Clinical & Experimental Metastasis

Fig. 1   Disease-free survival for patients (n=125) with more than 1 node positive (N2–N3). Patients who had only sentinel nodes positive (n=64) had sig- nificantly better disease-free and overall (not shown, p =0.00003) survival than those patients with a positive non-sentinel node (n=61)

the SLN having a significant DFS advantage over patients with SLN and NSLN positive disease (p=0.00003). These results hold despite the total number of nodes involved with disease. Figure 2 illustrates DFS for patients with N2 disease (those with 2–3 nodes positive). If the dis- ease is confined to the SLNs, patients had a better DFS (p = 0.00001), regardless of total number of nodes posi- tive. In fact, when patients with N2 disease (2–3 nodes

positive) were distinguished by the type of nodes positive, those with only SLNs positive had survival that was simi- lar to those patients with only 1 node positive (N1), while those with at least one NSLN positive had a significantly worse prognosis. Patients with one, two and three nodes positive with SLN-only disease had a similar 5 year DFS. Patients with Stage III metastatic melanoma, which is disease that has spread to the regional basin, are a

Fig. 2   Disease-free survival for patients (n=93) with 2–3 nodes positive (N2). Patients who had only sentinel nodes positive (n=62) had significantly better disease-free and overall (not shown, p =0.00356) survival than those patients with a posi- tive non-sentinel node (n=31)

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