Prognosis in patients with sentinel node‐positive melanoma without immediate completion lymph node dissection
Identifieur interne : 000283 ( Istex/Corpus ); précédent : 000282; suivant : 000284Prognosis in patients with sentinel node‐positive melanoma without immediate completion lymph node dissection
Auteurs : A. P. T. Van Der Ploeg ; A. C. J. Van Akkooi ; P. Rutkowski ; M. Cook ; O. E. Nieweg ; C. R. Rossi ; A. Testori ; S. Suciu ; C. Verhoef ; A. M. M. EggermontSource :
- British Journal of Surgery [ 0007-1323 ] ; 2012-10.
Abstract
The therapeutic value of immediate completion lymph node dissection (CLND) for sentinel node (SN)‐positive melanoma is unknown. The aim of this study was to evaluate the impact of immediate CLND on the outcome of patients with SN‐positive melanoma.
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DOI: 10.1002/bjs.8878
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P. T." last="Van Der Ploeg">A. P. T. Van Der Ploeg</name><affiliation><mods:affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Van Akkooi, A C J" sort="Van Akkooi, A C J" uniqKey="Van Akkooi A" first="A. C. J." last="Van Akkooi">A. C. J. Van Akkooi</name><affiliation><mods:affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Rutkowski, P" sort="Rutkowski, P" uniqKey="Rutkowski P" first="P." last="Rutkowski">P. Rutkowski</name><affiliation><mods:affiliation>M. Sklodowska‐Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland</mods:affiliation></affiliation></author><author><name sortKey="Cook, M" sort="Cook, M" uniqKey="Cook M" first="M." last="Cook">M. Cook</name><affiliation><mods:affiliation>Royal Surrey County Hospital, Guildford, UK</mods:affiliation></affiliation></author><author><name sortKey="Nieweg, O E" sort="Nieweg, O E" uniqKey="Nieweg O" first="O. E." last="Nieweg">O. E. Nieweg</name><affiliation><mods:affiliation>Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Rossi, C R" sort="Rossi, C R" uniqKey="Rossi C" first="C. R." last="Rossi">C. R. Rossi</name><affiliation><mods:affiliation>Veneto Institute of Oncology—Istituto di Ricovero e Cura a Carattere Scientifico and University of Padua, Padua, Italy</mods:affiliation></affiliation></author><author><name sortKey="Testori, A" sort="Testori, A" uniqKey="Testori A" first="A." last="Testori">A. Testori</name><affiliation><mods:affiliation>European Institute of Oncology, Milan, Italy</mods:affiliation></affiliation></author><author><name sortKey="Suciu, S" sort="Suciu, S" uniqKey="Suciu S" first="S." last="Suciu">S. Suciu</name><affiliation><mods:affiliation>European Organization for Research and Treatment of Cancer, Headquarters, Brussels, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Verhoef, C" sort="Verhoef, C" uniqKey="Verhoef C" first="C." last="Verhoef">C. Verhoef</name><affiliation><mods:affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Eggermont, A M M" sort="Eggermont, A M M" uniqKey="Eggermont A" first="A. M. M." last="Eggermont">A. M. M. Eggermont</name><affiliation><mods:affiliation>Institut de Cancérologie Gustave Roussy, Villejuif, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut de Cancérologie Gustave Roussy, Villejuif Cedex 94805, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">British Journal of Surgery</title><title level="j" type="alt">BRITISH JOURNAL OF SURGERY</title><idno type="ISSN">0007-1323</idno><idno type="eISSN">1365-2168</idno><imprint><biblScope unit="vol">99</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1396">1396</biblScope><biblScope unit="page" to="1405">1405</biblScope><biblScope unit="page-count">10</biblScope><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2012-10">2012-10</date></imprint><idno type="ISSN">0007-1323</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0007-1323</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">The therapeutic value of immediate completion lymph node dissection (CLND) for sentinel node (SN)‐positive melanoma is unknown. 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Published by John Wiley & Sons, Ltd.</licence></availability><date type="published" when="2012-10"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main" xml:lang="en">Prognosis in patients with sentinel node‐positive melanoma without immediate completion lymph node dissection<ref type="note" target="#fn11"></ref></title><title level="a" type="short" xml:lang="en">Completion lymph node dissection in sentinel node‐positive melanoma</title><author xml:id="author-0000"><persName><forename type="first">A. P. T.</forename><surname>van der Ploeg</surname></persName><affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands<address><country key="NL"></country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">A. C. J.</forename><surname>van Akkooi</surname></persName><affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands<address><country key="NL"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">P.</forename><surname>Rutkowski</surname></persName><affiliation>M. Sklodowska‐Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland<address><country key="PL"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">M.</forename><surname>Cook</surname></persName><affiliation>Royal Surrey County Hospital, Guildford, UK<address><country key="GB"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">O. E.</forename><surname>Nieweg</surname></persName><affiliation>Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands<address><country key="NL"></country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">C. R.</forename><surname>Rossi</surname></persName><affiliation>Veneto Institute of Oncology—Istituto di Ricovero e Cura a Carattere Scientifico and University of Padua, Padua, Italy<address><country key="IT"></country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">A.</forename><surname>Testori</surname></persName><affiliation>European Institute of Oncology, Milan, Italy<address><country key="IT"></country></address></affiliation></author><author xml:id="author-0007"><persName><forename type="first">S.</forename><surname>Suciu</surname></persName><affiliation>European Organization for Research and Treatment of Cancer, Headquarters, Brussels, Belgium<address><country key="BE"></country></address></affiliation></author><author xml:id="author-0008"><persName><forename type="first">C.</forename><surname>Verhoef</surname></persName><affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands<address><country key="NL"></country></address></affiliation></author><author xml:id="author-0009" role="corresp"><persName><forename type="first">A. M. M.</forename><surname>Eggermont</surname></persName><email>alexander.eggermont@igr.fr</email><affiliation>Institut de Cancérologie Gustave Roussy, Villejuif, France<address><country key="FR"></country></address></affiliation><affiliation>Institut de Cancérologie Gustave Roussy, Villejuif Cedex 94805, France</affiliation></author><author xml:id="author-0010"><author><orgName>for the European Organization for Research and Treatment of Cancer Melanoma Group</orgName></author></author><idno type="istex">061F758F1D426D5F1D00280ABE693F15D7ABEDB7</idno><idno type="DOI">10.1002/bjs.8878</idno><idno type="unit">BJS8878</idno><idno type="toTypesetVersion">file:BJS.BJS8878.pdf</idno></analytic><monogr><title level="j" type="main">British Journal of Surgery</title><title level="j" type="alt">BRITISH JOURNAL OF SURGERY</title><idno type="pISSN">0007-1323</idno><idno type="eISSN">1365-2168</idno><idno type="book-DOI">10.1002/(ISSN)1365-2168</idno><idno type="book-part-DOI">10.1002/bjs.v99.10</idno><idno type="product">BJS</idno><imprint><biblScope unit="vol">99</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1396">1396</biblScope><biblScope unit="page" to="1405">1405</biblScope><biblScope unit="page-count">10</biblScope><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2012-10"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head>
Background:
<p>The therapeutic value of immediate completion lymph node dissection (CLND) for sentinel node (SN)‐positive melanoma is unknown. The aim of this study was to evaluate the impact of immediate CLND on the outcome of patients with SN‐positive melanoma.</p>
Methods:
<p>Patients with SN metastases treated between 1993 and 2008 at ten cancer centres from the European Organization for Research and Treatment of Cancer Melanoma Group were included in this retrospective study. Maximum tumour size, intranodal location and penetrative depth of SN metastases were measured. Outcome in those who had CLND was compared with that in patients who did not undergo completion lymphadenectomy.</p>
Results:
<p>Of 1174 patients with SN‐positive melanoma, 1113 (94·8 per cent) underwent CLND and 61 (5·2 per cent) did not. Median follow‐up for the two groups was 34 and 48 months respectively. In univariable survival analysis, CLND did not significantly influence disease‐specific survival (hazard ratio (HR) 0·89, 95 per cent confidence interval 0·58 to 1·37; <hi rend="italic">P</hi> = 0·600). However, patients who did not undergo CLND had more favourable prognostic factors. Matched‐pair analysis, with matching for age, Breslow thickness, tumour ulceration and SN tumour burden, showed that CLND had no influence on survival (HR 0·86, 0·46 to 1·61; <hi rend="italic">P</hi> = 0·640). After adjusting for prognostic factors in multivariable survival analyses, no difference in survival was found.</p>
Conclusion:
<p>In these two cohorts of patients with SN‐positive melanoma and prognostic heterogeneity, outcome was not influenced by CLND. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</p></abstract><abstract xml:lang="en" style="short"><p>No difference in survival</p></abstract><textClass><classCode scheme="articleCategory">Original Article</classCode><classCode scheme="tocHeading1">Original Articles</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/061F758F1D426D5F1D00280ABE693F15D7ABEDB7/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>John Wiley & Sons, Ltd.</publisherName><publisherLoc>Chichester, UK</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1365-2168</doi><issn type="print">0007-1323</issn><issn type="electronic">1365-2168</issn><idGroup><id type="product" value="BJS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="BRITISH JOURNAL OF SURGERY">British Journal of Surgery</title><title type="short">Br J Surg</title></titleGroup></publicationMeta><publicationMeta level="part" position="100"><doi origin="wiley" registered="yes">10.1002/bjs.v99.10</doi><numberingGroup><numbering type="journalVolume" number="99">99</numbering><numbering type="journalIssue">10</numbering></numberingGroup><coverDate startDate="2012-10">October 2012</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="130" status="forIssue"><doi origin="wiley" registered="yes">10.1002/bjs.8878</doi><idGroup><id type="unit" value="BJS8878"></id></idGroup><countGroup><count type="pageTotal" number="10"></count></countGroup><titleGroup><title type="articleCategory">Original Article</title><title type="tocHeading1">Original Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2012 British Journal of Surgery Society Ltd. 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P. T.</givenNames><familyName>van der Ploeg</familyName></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>A. C. J.</givenNames><familyName>van Akkooi</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>P.</givenNames><familyName>Rutkowski</familyName></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af4"><personName><givenNames>M.</givenNames><familyName>Cook</familyName></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af2"><personName><givenNames>O. E.</givenNames><familyName>Nieweg</familyName></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af5"><personName><givenNames>C. R.</givenNames><familyName>Rossi</familyName></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af6"><personName><givenNames>A.</givenNames><familyName>Testori</familyName></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af7"><personName><givenNames>S.</givenNames><familyName>Suciu</familyName></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af1"><personName><givenNames>C.</givenNames><familyName>Verhoef</familyName></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af8" corresponding="yes"><personName><givenNames>A. M. M.</givenNames><familyName>Eggermont</familyName></personName><contactDetails><email>alexander.eggermont@igr.fr</email></contactDetails></creator><creator xml:id="au11" creatorRole="author"><groupName>for the European Organization for Research and Treatment of Cancer Melanoma Group</groupName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="NL" type="organization"><unparsedAffiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="NL" type="organization"><unparsedAffiliation>Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="PL" type="organization"><unparsedAffiliation>M. Sklodowska‐Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="GB" type="organization"><unparsedAffiliation>Royal Surrey County Hospital, Guildford, UK</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="IT" type="organization"><unparsedAffiliation>Veneto Institute of Oncology—Istituto di Ricovero e Cura a Carattere Scientifico and University of Padua, Padua, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="IT" type="organization"><unparsedAffiliation>European Institute of Oncology, Milan, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="BE" type="organization"><unparsedAffiliation>European Organization for Research and Treatment of Cancer, Headquarters, Brussels, Belgium</unparsedAffiliation></affiliation><affiliation xml:id="af8" countryCode="FR" type="organization"><unparsedAffiliation>Institut de Cancérologie Gustave Roussy, Villejuif, France</unparsedAffiliation></affiliation></affiliationGroup><supportingInformation><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:00071323:media:bjs8878:bjs_8878_sm_suppinfo"></mediaResource><caption>Supporting Information</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background:</title><p>The therapeutic value of immediate completion lymph node dissection (CLND) for sentinel node (SN)‐positive melanoma is unknown. The aim of this study was to evaluate the impact of immediate CLND on the outcome of patients with SN‐positive melanoma.</p></section><section xml:id="abs1-2"><title type="main">Methods:</title><p>Patients with SN metastases treated between 1993 and 2008 at ten cancer centres from the European Organization for Research and Treatment of Cancer Melanoma Group were included in this retrospective study. Maximum tumour size, intranodal location and penetrative depth of SN metastases were measured. Outcome in those who had CLND was compared with that in patients who did not undergo completion lymphadenectomy.</p></section><section xml:id="abs1-3"><title type="main">Results:</title><p>Of 1174 patients with SN‐positive melanoma, 1113 (94·8 per cent) underwent CLND and 61 (5·2 per cent) did not. Median follow‐up for the two groups was 34 and 48 months respectively. In univariable survival analysis, CLND did not significantly influence disease‐specific survival (hazard ratio (HR) 0·89, 95 per cent confidence interval 0·58 to 1·37; <i>P</i> = 0·600). However, patients who did not undergo CLND had more favourable prognostic factors. Matched‐pair analysis, with matching for age, Breslow thickness, tumour ulceration and SN tumour burden, showed that CLND had no influence on survival (HR 0·86, 0·46 to 1·61; <i>P</i> = 0·640). After adjusting for prognostic factors in multivariable survival analyses, no difference in survival was found.</p></section><section xml:id="abs1-4"><title type="main">Conclusion:</title><p>In these two cohorts of patients with SN‐positive melanoma and prognostic heterogeneity, outcome was not influenced by CLND. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</p></section></abstract><abstract type="short" xml:lang="en"><p>No difference in survival</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn11"><p>Presented in part to the Annual Meeting of the American Society of Clinical Oncology, Orlando, Florida, USA, June 2009, the Seventh Meeting of the International Sentinel Node Society, Yokohama, Japan, November 2010, and the European Multidisciplinary Cancer Congress, Stockholm, Sweden, September 2011</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Prognosis in patients with sentinel node‐positive melanoma without immediate completion lymph node dissection</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Completion lymph node dissection in sentinel node‐positive melanoma</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Prognosis in patients with sentinel node‐positive melanoma without immediate completion lymph node dissection</title></titleInfo><name type="personal"><namePart type="given">A. P. T.</namePart><namePart type="family">van der Ploeg</namePart><affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A. C. J.</namePart><namePart type="family">van Akkooi</namePart><affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P.</namePart><namePart type="family">Rutkowski</namePart><affiliation>M. Sklodowska‐Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Cook</namePart><affiliation>Royal Surrey County Hospital, Guildford, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">O. E.</namePart><namePart type="family">Nieweg</namePart><affiliation>Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C. R.</namePart><namePart type="family">Rossi</namePart><affiliation>Veneto Institute of Oncology—Istituto di Ricovero e Cura a Carattere Scientifico and University of Padua, Padua, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Testori</namePart><affiliation>European Institute of Oncology, Milan, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Suciu</namePart><affiliation>European Organization for Research and Treatment of Cancer, Headquarters, Brussels, Belgium</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Verhoef</namePart><affiliation>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A. M. M.</namePart><namePart type="family">Eggermont</namePart><affiliation>Institut de Cancérologie Gustave Roussy, Villejuif, France</affiliation><affiliation>Institut de Cancérologie Gustave Roussy, Villejuif Cedex 94805, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="corporate"><namePart>for the European Organization for Research and Treatment of Cancer Melanoma Group</namePart><description>Erasmus University Medical Centre—Daniel den Hoed Cancer Centre, Rotterdam, The NetherlandsNetherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The NetherlandsM. Sklodowska‐Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, PolandRoyal Surrey County Hospital, Guildford, UKVeneto Institute of Oncology—Istituto di Ricovero e Cura a Carattere Scientifico and University of Padua, Padua, ItalyEuropean Institute of Oncology, Milan, ItalyEuropean Organization for Research and Treatment of Cancer, Headquarters, Brussels, BelgiumInstitut de Cancérologie Gustave Roussy, Villejuif, France</description></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>John Wiley & Sons, Ltd.</publisher><place><placeTerm type="text">Chichester, UK</placeTerm></place><dateIssued encoding="w3cdtf">2012-10</dateIssued><dateValid encoding="w3cdtf">2012-06-11</dateValid><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">4</extent><extent unit="references">32</extent></physicalDescription><abstract>The therapeutic value of immediate completion lymph node dissection (CLND) for sentinel node (SN)‐positive melanoma is unknown. The aim of this study was to evaluate the impact of immediate CLND on the outcome of patients with SN‐positive melanoma.</abstract><abstract>Patients with SN metastases treated between 1993 and 2008 at ten cancer centres from the European Organization for Research and Treatment of Cancer Melanoma Group were included in this retrospective study. Maximum tumour size, intranodal location and penetrative depth of SN metastases were measured. Outcome in those who had CLND was compared with that in patients who did not undergo completion lymphadenectomy.</abstract><abstract>Of 1174 patients with SN‐positive melanoma, 1113 (94·8 per cent) underwent CLND and 61 (5·2 per cent) did not. Median follow‐up for the two groups was 34 and 48 months respectively. In univariable survival analysis, CLND did not significantly influence disease‐specific survival (hazard ratio (HR) 0·89, 95 per cent confidence interval 0·58 to 1·37; P = 0·600). However, patients who did not undergo CLND had more favourable prognostic factors. Matched‐pair analysis, with matching for age, Breslow thickness, tumour ulceration and SN tumour burden, showed that CLND had no influence on survival (HR 0·86, 0·46 to 1·61; P = 0·640). After adjusting for prognostic factors in multivariable survival analyses, no difference in survival was found.</abstract><abstract>In these two cohorts of patients with SN‐positive melanoma and prognostic heterogeneity, outcome was not influenced by CLND. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</abstract><abstract type="short" lang="en">No difference in survival</abstract><note type="additional physical form">Supporting Information</note><note type="content">*Presented in part to the Annual Meeting of the American Society of Clinical Oncology, Orlando, Florida, USA, June 2009, the Seventh Meeting of the International Sentinel Node Society, Yokohama, Japan, November 2010, and the European Multidisciplinary Cancer Congress, Stockholm, Sweden, September 2011</note><relatedItem type="host"><titleInfo><title>British Journal of Surgery</title></titleInfo><titleInfo type="abbreviated"><title>Br J Surg</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Original Article</topic></subject><identifier type="ISSN">0007-1323</identifier><identifier type="eISSN">1365-2168</identifier><identifier type="DOI">10.1002/(ISSN)1365-2168</identifier><identifier type="PublisherID">BJS</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>99</number></detail><detail type="issue"><caption>no.</caption><number>10</number></detail><extent unit="pages"><start>1396</start><end>1405</end><total>10</total></extent></part></relatedItem><identifier type="istex">061F758F1D426D5F1D00280ABE693F15D7ABEDB7</identifier><identifier type="DOI">10.1002/bjs.8878</identifier><identifier type="ArticleID">BJS8878</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2012 British Journal of Surgery Society Ltd. 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