R. Heller et al., IDENTIFICATION OF SUBMICROSCOPIC LYMPH-NODE METASTASES IN PATIENTS WITH MALIGNANT-MELANOMA, Seminars in surgical oncology, 9(3), 1993, pp. 285-289
In order to detect micrometastatic disease, our laboratory has develop
ed a method for evaluating lymph node sections from patients with stag
e 1 or 2 melanoma. Lymph nodes isolated from standard dissections are
bivalved; one half is subjected to routine histopathological evaluatio
n and the other half disrupted and placed into cell culture. The cultu
red cells are identified by cytologic examination, immunohistologic st
aining, and the presence of melanoma-associated antigens. Lymph nodes
(448) from 62 patients with malignant melanoma were evaluated by tissu
e culture. Fifteen patients were upgraded from stage 1 or 2 to stage 3
disease after micrometastases were identified in lymph node cultures.
Recurrence of disease in histologically node negative patients, durin
g a mean 24-month follow-up, has only been observed thus far in patien
ts with culture positive lymph nodes. In addition. these results add e
vidence to the belief that missed micrometastatic disease in regional
nodes is a sign of occult systemic metastases that would account for t
he defined recurrence rate in histologically node negative patients.