BACKGROUND: The objectives of this analysis were to compare various measures associated with lymph node (LN) dissection and to identify threshold values associated with disease-specific survival (DSS) outcomes in patients with melanoma. METHODS: Patients with lymph node-positive melanoma who underwent therapeutic LN dissection of the neck, axilla, and inguinal region were identified from the SEER database (1988-2005). We performed Cox multivariate analyses to determine the impact of the total number of LNs removed, number of negative LNs removed, and LN ratio on DSS. Multivariate cut-point analyses were conducted for each anatomic region to identify the threshold values associated with the largest improvement in DSS. RESULTS: The LN ratio was significantly associated with DSS for all LN regions. The LN ratio thresholds resulting in the greatest difference in 5-year DSS were .07, .13, and .18 for neck, axillary, and inguinal regions, respectively, corresponding to 15, 8, and 6 LNs removed per positive lymph node. After adjustment for other clinicopathologic factors, the hazard ratios (HRs) were .53 (95% confidence interval [CI], .40 to .71) in the neck, .52 (95% CI, .42 to .65) in the axillary, and .47 (95% CI, .36 to .61) in the inguinal regions for patients who met the LN ratio threshold. CONCLUSIONS: Among the prognostic factors examined, LN ratio was the best indicator of the extent of LN dissection, regardless of anatomic nodal region. These data provide evidence-based guidelines for defining adequate LN dissections in melanoma patients. (c) 2009 American Cancer Society.
BACKGROUND: The objectives of this analysis were to compare various measures associated with lymph node (LN) dissection and to identify threshold values associated with disease-specific survival (DSS) outcomes in patients with melanoma. METHODS:Patients with lymph node-positive melanoma who underwent therapeutic LN dissection of the neck, axilla, and inguinal region were identified from the SEER database (1988-2005). We performed Cox multivariate analyses to determine the impact of the total number of LNs removed, number of negative LNs removed, and LN ratio on DSS. Multivariate cut-point analyses were conducted for each anatomic region to identify the threshold values associated with the largest improvement in DSS. RESULTS: The LN ratio was significantly associated with DSS for all LN regions. The LN ratio thresholds resulting in the greatest difference in 5-year DSS were .07, .13, and .18 for neck, axillary, and inguinal regions, respectively, corresponding to 15, 8, and 6 LNs removed per positive lymph node. After adjustment for other clinicopathologic factors, the hazard ratios (HRs) were .53 (95% confidence interval [CI], .40 to .71) in the neck, .52 (95% CI, .42 to .65) in the axillary, and .47 (95% CI, .36 to .61) in the inguinal regions for patients who met the LN ratio threshold. CONCLUSIONS: Among the prognostic factors examined, LN ratio was the best indicator of the extent of LN dissection, regardless of anatomic nodal region. These data provide evidence-based guidelines for defining adequate LN dissections in melanomapatients. (c) 2009 American Cancer Society.
Authors: C Galliot-Repkat; R Cailliod; O Trost; A Danino; E Collet; D Lambert; P Vabres; S Dalac Journal: Eur J Surg Oncol Date: 2006-07-05 Impact factor: 4.424
Authors: Elfriede Bollschweiler; Stephan E Baldus; Wolfgang Schröder; Paul M Schneider; Arnulf H Hölscher Journal: J Surg Oncol Date: 2006-10-01 Impact factor: 3.454
Authors: Donald L Morton; John F Thompson; Alistair J Cochran; Nicola Mozzillo; Robert Elashoff; Richard Essner; Omgo E Nieweg; Daniel F Roses; Harald J Hoekstra; Constantine P Karakousis; Douglas S Reintgen; Brendon J Coventry; Edwin C Glass; He-Jing Wang Journal: N Engl J Med Date: 2006-09-28 Impact factor: 91.245
Authors: James W Jakub; Alicia M Terando; Amod Sarnaik; Charlotte E Ariyan; Mark B Faries; Sabino Zani; Heather B Neuman; Nabil Wasif; Jeffrey M Farma; Bruce J Averbook; Karl Y Bilimoria; Travis E Grotz; Jacob B Jake Allred; Vera J Suman; Mary Sue Brady; Douglas Tyler; Jeffrey D Wayne; Heidi Nelson Journal: Ann Surg Date: 2017-01 Impact factor: 12.969
Authors: Carrie K Chu; Keith A Delman; Grant W Carlson; Andrea C Hestley; Douglas R Murray Journal: Ann Surg Oncol Date: 2011-05-04 Impact factor: 5.344
Authors: Nakul P Valsangkar; Devon M Bush; James S Michaelson; Cristina R Ferrone; Jennifer A Wargo; Keith D Lillemoe; Carlos Fernández-del Castillo; Andrew L Warshaw; Sarah P Thayer Journal: J Gastrointest Surg Date: 2012-12-11 Impact factor: 3.452
Authors: David J Nusbaum; Rachel S Mandelbaum; Hiroko Machida; Shinya Matsuzaki; Lynda D Roman; Anil K Sood; David M Gershenson; Koji Matsuo Journal: Arch Gynecol Obstet Date: 2020-04-17 Impact factor: 2.344
Authors: A P T van der Ploeg; A C J van Akkooi; P I M Schmitz; A N van Geel; J H de Wilt; A M M Eggermont; C Verhoef Journal: Ann Surg Oncol Date: 2011-05-03 Impact factor: 5.344
Authors: A M Manganoni; R Farfaglia; E Sereni; C Farisoglio; C Pizzocaro; D Marocolo; F Gavazzoni; L Pavoni; P Calzavara-Pinton Journal: Dermatol Res Pract Date: 2011-05-04
Authors: K P Wevers; E Bastiaannet; H P A M Poos; R J van Ginkel; J T Plukker; H J Hoekstra Journal: Ann Surg Oncol Date: 2012-05-17 Impact factor: 5.344