Is a level III dissection necessary for a positive sentinel lymph node in melanoma?
Identifieur interne : 000493 ( Istex/Corpus ); précédent : 000492; suivant : 000494Is a level III dissection necessary for a positive sentinel lymph node in melanoma?
Auteurs : Jukes P. Namm ; Alfred E. Chang ; Vincent M. Cimmino ; Riley S. Rees ; Timothy M. Johnson ; Michael S. SabelSource :
- Journal of Surgical Oncology [ 0022-4790 ] ; 2012-03-01.
Abstract
For melanoma patients with a positive axillary SLN, the extent of ALND remains controversial, with debate over whether a level III dissection is needed.
Url:
DOI: 10.1002/jso.22076
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Rees</name><affiliation><mods:affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</mods:affiliation></affiliation></author><author><name sortKey="Johnson, Timothy M" sort="Johnson, Timothy M" uniqKey="Johnson T" first="Timothy M." last="Johnson">Timothy M. Johnson</name><affiliation><mods:affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan</mods:affiliation></affiliation></author><author><name sortKey="Sabel, Michael S" sort="Sabel, Michael S" uniqKey="Sabel M" first="Michael S." last="Sabel">Michael S. Sabel</name><affiliation><mods:affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</mods:affiliation></affiliation><affiliation><mods:affiliation>3304 Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109. Fax: +1‐734‐647‐9647.===</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Surgical Oncology</title><title level="j" type="alt">JOURNAL OF SURGICAL ONCOLOGY</title><idno type="ISSN">0022-4790</idno><idno type="eISSN">1096-9098</idno><imprint><biblScope unit="vol">105</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="225">225</biblScope><biblScope unit="page" to="228">228</biblScope><biblScope unit="page-count">4</biblScope><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2012-03-01">2012-03-01</date></imprint><idno type="ISSN">0022-4790</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-4790</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">For melanoma patients with a positive axillary SLN, the extent of ALND remains controversial, with debate over whether a level III dissection is needed.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>node</json:string><json:string>melanoma</json:string><json:string>axillary</json:string><json:string>alnd</json:string><json:string>surg</json:string><json:string>recurrence</json:string><json:string>clnd</json:string><json:string>oncol</json:string><json:string>regional recurrence rate</json:string><json:string>dissection</json:string><json:string>lymph</json:string><json:string>nodal</json:string><json:string>morbidity</json:string><json:string>regional recurrence</json:string><json:string>median</json:string><json:string>surg oncol</json:string><json:string>median number</json:string><json:string>breast cancer</json:string><json:string>surgical oncology</json:string><json:string>sentinel lymph node biopsy</json:string><json:string>melanoma patients</json:string><json:string>sentinel</json:string><json:string>surgical</json:string><json:string>biopsy</json:string><json:string>upper extremity</json:string><json:string>axillary clnd</json:string><json:string>malignant melanoma</json:string><json:string>distant disease</json:string><json:string>axillary lymph node dissection</json:string><json:string>axillary dissection</json:string><json:string>patients mapping</json:string><json:string>more nodes</json:string><json:string>complication rate</json:string><json:string>level alnd</json:string><json:string>pectoralis</json:string></teeft></keywords><author><json:item><name>Jukes P. Namm MD</name><affiliations><json:string>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</json:string></affiliations></json:item><json:item><name>Alfred E. Chang MD</name><affiliations><json:string>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</json:string></affiliations></json:item><json:item><name>Vincent M. Cimmino MD</name><affiliations><json:string>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</json:string></affiliations></json:item><json:item><name>Riley S. Rees MD</name><affiliations><json:string>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</json:string></affiliations></json:item><json:item><name>Timothy M. Johnson MD</name><affiliations><json:string>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</json:string><json:string>Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan</json:string></affiliations></json:item><json:item><name>Michael S. Sabel MD</name><affiliations><json:string>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</json:string><json:string>3304 Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109. 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Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><licence>Copyright © 2011 Wiley Periodicals, Inc</licence></availability><date type="published" when="2012-03-01"></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">Is a level III dissection necessary for a positive sentinel lymph node in melanoma?</title><title level="a" type="short" xml:lang="en">ALND for Melanoma SLN</title><author xml:id="author-0000"><persName><forename type="first">Jukes P.</forename><surname>Namm</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan<address><country key="US"></country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">Alfred E.</forename><surname>Chang</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan<address><country key="US"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Vincent M.</forename><surname>Cimmino</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan<address><country key="US"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Riley S.</forename><surname>Rees</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan<address><country key="US"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Timothy M.</forename><surname>Johnson</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan<address><country key="US"></country></address></affiliation><affiliation>Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan<address><country key="US"></country></address></affiliation></author><author xml:id="author-0005" role="corresp"><persName><forename type="first">Michael S.</forename><surname>Sabel</surname><roleName type="degree">MD</roleName></persName><email>msabel@umich.edu</email><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan<address><country key="US"></country></address></affiliation><affiliation>3304 Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109. Fax: +1‐734‐647‐9647.===</affiliation></author><idno type="istex">0AAAB6C33A51FADB4C4F49CB47ECC5C2E3F6ADD7</idno><idno type="DOI">10.1002/jso.22076</idno><idno type="unit">JSO22076</idno><idno type="toTypesetVersion">file:JSO.JSO22076.pdf</idno></analytic><monogr><title level="j" type="main">Journal of Surgical Oncology</title><title level="j" type="alt">JOURNAL OF SURGICAL ONCOLOGY</title><idno type="pISSN">0022-4790</idno><idno type="eISSN">1096-9098</idno><idno type="book-DOI">10.1002/(ISSN)1096-9098</idno><idno type="book-part-DOI">10.1002/jso.v105.3</idno><idno type="product">JSO</idno><imprint><biblScope unit="vol">105</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="225">225</biblScope><biblScope unit="page" to="228">228</biblScope><biblScope unit="page-count">4</biblScope><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2012-03-01"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head>
Background
<p>For melanoma patients with a positive axillary SLN, the extent of ALND remains controversial, with debate over whether a level III dissection is needed.</p>
Methods
<p>We queried our IRB approved prospective database for patients with a positive axillary SLN who had a level I/II dissection only, and compared recurrence and complication rates to the existing literature.</p>
Results
<p>Between 1998 and 2008, 270 patients had 285 level I/II ALNDs for a positive SLN. Median number of SLN removed was 2, while the median number of involved SLN was 1 (range 1–4). An average of 18.7 nodes/ALND were removed, with 13% having positive non‐SLN. Post‐operative complications occurred in 31 patients (11%), primarily cellulitis (8%). After a mean follow‐up of 44 months, 14 patients had a regional recurrence in the axillary basin (5%).</p>
Conclusions
<p>The complication rate and regional recurrence rate for patients undergoing a level I/II ALND for a positive SLN are either lower than or on par with reported series of ALND for level I, II, and III dissections, suggesting that in this setting, the level III dissection may be of minimal benefit. J. Surg. Oncol. 2012; 105:225–228. © 2011 Wiley Periodicals, Inc.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="kwd1">melanoma</term><term xml:id="kwd2">sentinel lymph node biopsy</term><term xml:id="kwd3">axillary lymph node dissection</term></keywords><classCode scheme="articleCategory">Research Article</classCode><classCode scheme="tocHeading1">Research 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/0AAAB6C33A51FADB4C4F49CB47ECC5C2E3F6ADD7/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>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1096-9098</doi><issn type="print">0022-4790</issn><issn type="electronic">1096-9098</issn><idGroup><id type="product" value="JSO"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="JOURNAL OF SURGICAL ONCOLOGY">Journal of Surgical Oncology</title><title type="short">J. 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Oncol.</title></titleGroup></publicationMeta><publicationMeta level="part" position="30"><doi origin="wiley" registered="yes">10.1002/jso.v105.3</doi><numberingGroup><numbering type="journalVolume" number="105">105</numbering><numbering type="journalIssue">3</numbering></numberingGroup><coverDate startDate="2012-03-01">1 March 2012</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="30" status="forIssue"><doi origin="wiley" registered="yes">10.1002/jso.22076</doi><idGroup><id type="unit" value="JSO22076"></id></idGroup><countGroup><count type="pageTotal" number="4"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="publisher">Copyright © 2011 Wiley Periodicals, Inc</copyright><eventGroup><event type="manuscriptReceived" date="2011-01-11"></event><event type="manuscriptAccepted" date="2011-07-28"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:3.3.3 mode:FullText" date="2014-08-12"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.3.3 mode:FullText" date="2014-08-12"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-08-22"></event><event type="publishedOnlineFinalForm" date="2012-01-23"></event><event type="firstOnline" date="2011-08-22"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.3.4 mode:FullText" date="2015-02-24"></event></eventGroup><numberingGroup><numbering type="pageFirst">225</numbering><numbering type="pageLast">228</numbering></numberingGroup><correspondenceTo>3304 Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109. Fax: +1‐734‐647‐9647.===</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JSO.JSO22076.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="1"></count><count type="referenceTotal" number="25"></count><count type="wordTotal" number="3772"></count></countGroup><titleGroup><title type="main" xml:lang="en">Is a level III dissection necessary for a positive sentinel lymph node in melanoma?</title><title type="short" xml:lang="en">ALND for Melanoma SLN</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Jukes P.</givenNames><familyName>Namm</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Alfred E.</givenNames><familyName>Chang</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Vincent M.</givenNames><familyName>Cimmino</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Riley S.</givenNames><familyName>Rees</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Timothy M.</givenNames><familyName>Johnson</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Michael S.</givenNames><familyName>Sabel</familyName><degrees>MD</degrees></personName><contactDetails><email>msabel@umich.edu</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">melanoma</keyword><keyword xml:id="kwd2">sentinel lymph node biopsy</keyword><keyword xml:id="kwd3">axillary lymph node dissection</keyword></keywordGroup><fundingInfo><fundingAgency>NIH Institutional Training Grant</fundingAgency><fundingNumber>T32</fundingNumber></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background</title><p>For melanoma patients with a positive axillary SLN, the extent of ALND remains controversial, with debate over whether a level III dissection is needed.</p></section><section xml:id="abs1-2"><title type="main">Methods</title><p>We queried our IRB approved prospective database for patients with a positive axillary SLN who had a level I/II dissection only, and compared recurrence and complication rates to the existing literature.</p></section><section xml:id="abs1-3"><title type="main">Results</title><p>Between 1998 and 2008, 270 patients had 285 level I/II ALNDs for a positive SLN. Median number of SLN removed was 2, while the median number of involved SLN was 1 (range 1–4). An average of 18.7 nodes/ALND were removed, with 13% having positive non‐SLN. Post‐operative complications occurred in 31 patients (11%), primarily cellulitis (8%). After a mean follow‐up of 44 months, 14 patients had a regional recurrence in the axillary basin (5%).</p></section><section xml:id="abs1-4"><title type="main">Conclusions</title><p>The complication rate and regional recurrence rate for patients undergoing a level I/II ALND for a positive SLN are either lower than or on par with reported series of ALND for level I, II, and III dissections, suggesting that in this setting, the level III dissection may be of minimal benefit. J. Surg. Oncol. 2012; 105:225–228. © 2011 Wiley Periodicals, Inc.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Is a level III dissection necessary for a positive sentinel lymph node in melanoma?</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>ALND for Melanoma SLN</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Is a level III dissection necessary for a positive sentinel lymph node in melanoma?</title></titleInfo><name type="personal"><namePart type="given">Jukes P.</namePart><namePart type="family">Namm</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alfred E.</namePart><namePart type="family">Chang</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Vincent M.</namePart><namePart type="family">Cimmino</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Riley S.</namePart><namePart type="family">Rees</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Timothy M.</namePart><namePart type="family">Johnson</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</affiliation><affiliation>Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael S.</namePart><namePart type="family">Sabel</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan</affiliation><affiliation>3304 Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109. Fax: +1‐734‐647‐9647.===</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2012-03-01</dateIssued><dateCaptured encoding="w3cdtf">2011-01-11</dateCaptured><dateValid encoding="w3cdtf">2011-07-28</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="tables">1</extent><extent unit="references">25</extent><extent unit="words">3772</extent></physicalDescription><abstract>For melanoma patients with a positive axillary SLN, the extent of ALND remains controversial, with debate over whether a level III dissection is needed.</abstract><abstract>We queried our IRB approved prospective database for patients with a positive axillary SLN who had a level I/II dissection only, and compared recurrence and complication rates to the existing literature.</abstract><abstract>Between 1998 and 2008, 270 patients had 285 level I/II ALNDs for a positive SLN. Median number of SLN removed was 2, while the median number of involved SLN was 1 (range 1–4). An average of 18.7 nodes/ALND were removed, with 13% having positive non‐SLN. Post‐operative complications occurred in 31 patients (11%), primarily cellulitis (8%). After a mean follow‐up of 44 months, 14 patients had a regional recurrence in the axillary basin (5%).</abstract><abstract>The complication rate and regional recurrence rate for patients undergoing a level I/II ALND for a positive SLN are either lower than or on par with reported series of ALND for level I, II, and III dissections, suggesting that in this setting, the level III dissection may be of minimal benefit. J. Surg. Oncol. 2012; 105:225–228. © 2011 Wiley Periodicals, Inc.</abstract><note type="funding">NIH Institutional Training Grant - No. T32; </note><subject lang="en"><genre>keywords</genre><topic>melanoma</topic><topic>sentinel lymph node biopsy</topic><topic>axillary lymph node dissection</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Surgical Oncology</title></titleInfo><titleInfo type="abbreviated"><title>J. Surg. Oncol.</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0022-4790</identifier><identifier type="eISSN">1096-9098</identifier><identifier type="DOI">10.1002/(ISSN)1096-9098</identifier><identifier type="PublisherID">JSO</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>105</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>225</start><end>228</end><total>4</total></extent></part></relatedItem><identifier type="istex">0AAAB6C33A51FADB4C4F49CB47ECC5C2E3F6ADD7</identifier><identifier type="DOI">10.1002/jso.22076</identifier><identifier type="ArticleID">JSO22076</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2011 Wiley Periodicals, Inc</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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