Literature DB >> 19474678

Is completion lymph node dissection needed in case of minimal melanoma metastasis in the sentinel node?

Iris M C van der Ploeg1, Bin B R Kroon, Ninja Antonini, Renato A Valdés Olmos, Omgo E Nieweg.   

Abstract

OBJECTIVE: The purpose of this study was to evaluate the micromorphometric Starz-classification in melanoma patients. SUMMARY BACKGROUND DATA: The micromorphometric Starz-classification suggests that melanoma patients with a sentinel node metastasis invading no more than 0.3 mm (S-I) or 0.31 to 1.0 mm (S-II) below the capsular level can be spared further surgery, while invasion of the metastasis of more than 1.0 mm (S-III) implies a need for completion dissection.
METHODS: Seventy patients with sentinel node metastases were studied. Twenty patients with an S-I or S-II classification were spared further surgery and 50 S-III patients underwent completion dissection. The median follow-up time was 33 months.
RESULTS: No lymph node recurrences were detected in the 20 S-I, II patients. Six of the 50 S-III patients (12%) had additional involved nodes in the dissection specimen. In these patients no recurrences developed in the cleared regional basins. Overall 3-year survival was 100% in the S-I, II patients and 80% in the S-III patients (P = 0.04). Three-year disease-free survival rates were 83% and 60%, respectively (P = 0.40).
CONCLUSIONS: : This study suggests that further surgery is unnecessary in S-I and S-II patients, while it does seem prudent to carry out completion dissection in S-III patients. The distinct survival difference between the 2 groups of patients suggests that the S-classification also has prognostic implications.

Entities:  

Mesh:

Year:  2009        PMID: 19474678     DOI: 10.1097/SLA.0b013e3181a77eba

Source DB:  PubMed          Journal:  Ann Surg        ISSN: 0003-4932            Impact factor:   12.969


  7 in total

Review 1.  Clinical utilities and biological characteristics of melanoma sentinel lymph nodes.

Authors:  Dale Han; Daniel C Thomas; Jonathan S Zager; Barbara Pockaj; Richard L White; Stanley Pl Leong
Journal:  World J Clin Oncol       Date:  2016-04-10

2.  Interobserver reproducibility of histologic parameters of melanoma deposits in sentinel lymph nodes: implications for management of patients with melanoma.

Authors:  Rajmohan Murali; Alistair J Cochran; Martin G Cook; Joseph D Hillman; Rooshdiya Z Karim; Marc Moncrieff; Hans Starz; John F Thompson; Richard A Scolyer
Journal:  Cancer       Date:  2009-11-01       Impact factor: 6.860

3.  SLN melanoma micrometastasis predictivity of nodal status: a long term retrospective study.

Authors:  Emilia Migliano; Barbara Bellei; Flavio Andrea Govoni; Giovanni Paolino; Caterina Catricalà; Stefania Bucher; Pietro Donati
Journal:  J Exp Clin Cancer Res       Date:  2013-08-01

4.  Evolving management of positive regional lymph nodes in melanoma: Past, present and future directions.

Authors:  Rachel A Fayne; Francisco I Macedo; Steven E Rodgers; Mecker G Möller
Journal:  Oncol Rev       Date:  2019-11-28

5.  Clinical performance indicators for monitoring the management of cutaneous melanoma: a population-based perspective.

Authors:  Alessandra Buja; Massimo Rugge; Giuseppe De Luca; Manuel Zorzi; Claudia Cozzolino; Antonella Vecchiato; Paolo Del Fiore; Saveria Tropea; Alberto Bortolami; Patrizia Benini; Carlo Riccardo Rossi; Simone Mocellin
Journal:  Melanoma Res       Date:  2022-07-19       Impact factor: 3.199

6.  Lymphatic drainage patterns from melanomas on the shoulder or upper trunk to cervical lymph nodes and implications for the extent of neck dissection.

Authors:  Hidde J Veenstra; W Martin C Klop; Maarten J Speijers; Peter J F M Lohuis; Omgo E Nieweg; Harald J Hoekstra; Alfons J M Balm
Journal:  Ann Surg Oncol       Date:  2012-05-11       Impact factor: 5.344

7.  Current management of patients with melanoma who are found to be sentinel node-positive.

Authors:  Amanda A G Nijhuis; Andrew J Spillane; Jonathan R Stretch; Robyn P M Saw; Alexander M Menzies; Roger F Uren; John F Thompson; Omgo E Nieweg
Journal:  ANZ J Surg       Date:  2019-10-30       Impact factor: 1.872

  7 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.