Is therapeutic lymph node dissection of value for lymph node recurrence in melanoma?

Distant metastasis-free survival Melanoma-specific survival Nodal recurrence Recurrence Sentinel lymph node Therapeutic lymph node dissection

Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
17 Oct 2023
Historique:
received: 18 07 2023
revised: 13 10 2023
accepted: 16 10 2023
medline: 6 11 2023
pubmed: 6 11 2023
entrez: 3 11 2023
Statut: aheadofprint

Résumé

Therapeutic lymphadenectomy (TLND) is still performed in most melanoma patients to treat nodal recurrences after initial negative lymph node biopsy (-SLNB), despite the lack of evidence for survival benefit. We sought to compare melanoma-specific survival (MSS) and distant metastasis-free survival (DMFS) of patients who underwent TLND versus no TLND using our institutional and MSTL-1 databases. We identified 146 patients with nodal recurrence following -SLNB: 132 underwent TLND and 14 did not. DMFS and MSS were evaluated for the cohorts followed by a matched-pair analysis between the cohorts. No difference was observed in five-year DMFS (p ​= ​0.454) and five-year MSS (p ​= ​0.945) between the two groups. The matched-pair analysis showed similar results (p ​= ​0.329 and p ​= ​0.363 for DMSF and MSS, respectively). From this limited retrospective study, TLND for nodal recurrence after a -SLNB does not appear to improve DMFS or MSS in melanoma patients compared to no TLND.

Sections du résumé

BACKGROUND BACKGROUND
Therapeutic lymphadenectomy (TLND) is still performed in most melanoma patients to treat nodal recurrences after initial negative lymph node biopsy (-SLNB), despite the lack of evidence for survival benefit. We sought to compare melanoma-specific survival (MSS) and distant metastasis-free survival (DMFS) of patients who underwent TLND versus no TLND using our institutional and MSTL-1 databases.
METHODS METHODS
We identified 146 patients with nodal recurrence following -SLNB: 132 underwent TLND and 14 did not. DMFS and MSS were evaluated for the cohorts followed by a matched-pair analysis between the cohorts.
RESULTS RESULTS
No difference was observed in five-year DMFS (p ​= ​0.454) and five-year MSS (p ​= ​0.945) between the two groups. The matched-pair analysis showed similar results (p ​= ​0.329 and p ​= ​0.363 for DMSF and MSS, respectively).
CONCLUSIONS CONCLUSIONS
From this limited retrospective study, TLND for nodal recurrence after a -SLNB does not appear to improve DMFS or MSS in melanoma patients compared to no TLND.

Identifiants

pubmed: 37923660
pii: S0002-9610(23)00564-0
doi: 10.1016/j.amjsurg.2023.10.035
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest RE serves on the advisory board for Castle Biosciences and Intramedical Imaging. AKW, TO, SS and KL have no conflict of interest.

Auteurs

Ana K Wilson (AK)

Saint John's Cancer Institute at Providence Saint John's Health Center, Department of Surgical Oncology, Santa Monica, CA, United States.

Kristel Lourdault (K)

Saint John's Cancer Institute at Providence Saint John's Health Center, Melanoma and CutaneousOncology Laboratory, Santa Monica, CA, United States.

Tara Ostad (T)

Saint John's Cancer Institute at Providence Saint John's Health Center, Melanoma and CutaneousOncology Laboratory, Santa Monica, CA, United States.

Stacey Stern (S)

Saint John's Cancer Institute at Providence Saint John's Health Center, Data Management/Biostatistics, Santa Monica, CA, United States.

Richard Essner (R)

Saint John's Cancer Institute at Providence Saint John's Health Center, Melanoma and CutaneousOncology Laboratory, Santa Monica, CA, United States. Electronic address: Richard.Essner@providence.org.

Classifications MeSH