+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Patients with lymphatic metastasis of cutaneous malignant melanoma benefit from sentinel lymphonodectomy and early excision of their nodal disease



Patients with lymphatic metastasis of cutaneous malignant melanoma benefit from sentinel lymphonodectomy and early excision of their nodal disease



European Journal of Cancer 40(2): 212-218



Early versus delayed excision of lymph node metastases is still being assessed in malignant melanoma. In the present retrospective, multicentre study, the outcome of 314 patients with positive sentinel lymphonodectomy (SLNE) was compared with the outcome of 623 patients with delayed lymph node dissection (DLND) of clinically enlarged lymph node metastases. In order to avoid the lead-time bias, survival was generally calculated from the excision of the primary tumour. Survival curves were constructed using the Kaplan-Meier product-limit estimate. Cox's proportional hazards model was used to perform a multivariate analysis of factors related to overall survival. Compared with SLNE and early performed complete lymph node dissection, DLND yielded a significantly higher number of lymph node metastases. Median and mean tumour thickness were nearly identical in the two therapy groups. The estimated 3-year overall survival rate was 80.1+/-2.8% (+/-standard error of the mean (SEM)) in patients with positive SLNs, and 67.6+/-1.9% in patients with DLND (5-year survival rates 62.5+/-5.5 and 50.2+/-5.4%, respectively). The difference between the two survival curves was statistically significant (P=0.002). Using multifactorial analysis, SLNE (P=0.000052), American Joint Committee on Cancer (AJCC) Breslow thickness category (P<0.000001), age (P=0.01) and gender (P=0.028) were independent predictors of overall survival. The location of the primary tumour (P=0.59) was non-significant. Considering only those centres with sufficient data for epidermal ulceration, this risk factor was also significant. In cutaneous malignant melanoma, early excision of lymphatic metastases, directed by the sentinel node procedure, provides a highly significant overall survival benefit.

(PDF emailed within 0-6 h: $19.90)

Accession: 012399026

Download citation: RISBibTeXText

PMID: 14728935

DOI: 10.1016/j.ejca.2003.07.003


Related references

Factors Predicting the Risk of In-Transit Recurrence After Sentinel Lymphonodectomy in Patients With Cutaneous Malignant Melanoma. Yearbook of Dermatology and Dermatologic Surgery 2007: 372-375, 2007

Factors predicting the risk of in-transit recurrence after sentinel lymphonodectomy in patients with cutaneous malignant melanoma. Annals of Surgical Oncology 13(8): 1105-1112, 2006

False-negative sentinel lymph node biopsy resulting from obstruction of lymphatic basin by nodal metastasis: a case report of malignant melanoma. Journal of Dermatology 38(11): 1121-1124, 2012

Postoperative morbidity of lymph node excision for cutaneous melanoma-sentinel lymphonodectomy versus complete regional lymph node dissection. Melanoma Research 18(1): 16-21, 2008

Lymphatic mapping and sentinel lymphonodectomy in recurrent cutaneous squamous cell carcinomas. European Journal of Dermatology 15(6): 478-479, 2005

Lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: therapeutic utility and implications of nodal microanatomy and molecular staging for improving the accuracy of detection of nodal micrometastases. Annals of Surgery 238(4): 538-49; Discussion 549-50, 2003

Lymphatic invasion in cutaneous melanoma is associated with sentinel lymph node metastasis. Journal of Cutaneous Pathology 36(7): 772-780, 2008

Sentinel Lymph Node Biopsy: Past and Present Implications for the Management of Cutaneous Melanoma with Nodal Metastasis. American Journal of Clinical Dermatology 19(Suppl 1): 24-30, 2018

"Sentinel" lymphonodectomy with scintillation detector. A new strategy in treatment of malignant melanoma. Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete 47(10): 754-758, 1996

Lymphatic transit rate as a predictive parameter for nodal metastasis in primary limb malignant melanoma. Journal of Dermatological Science 90(1): 27-34, 2018

Lymphatic invasion predicts sentinel lymph node metastasis and adverse outcome in primary cutaneous melanoma. Journal of Cutaneous Pathology 44(9): 734-739, 2017

Reassessing the role of lymphatic mapping and sentinel lymphadenectomy in the management of cutaneous malignant melanoma. Journal of the American Academy of Dermatology 49(4): 567-88; Quiz 589-92, 2003

Cost-effectiveness of preoperative SPECT/CT combined with lymphoscintigraphy vs. lymphoscintigraphy for sentinel lymph node excision in patients with cutaneous malignant melanoma. European Journal of Nuclear Medicine and Molecular Imaging 41(9): 1723-1731, 2015

Sentinel lymph node excision and PET-CT in the initial stage of malignant melanoma: a retrospective analysis of 61 patients with malignant melanoma in American Joint Committee on Cancer stages I and II. Dermatologic Surgery 36(4): 439-445, 2010

Sentinel lymphonodectomy does not increase the risk of loco-regional cutaneous metastases of malignant melanomas. European Journal of Cancer 41(4): 531-538, 2005