Combined inguinal and pelvic lymph node dissection for stage III melanoma
Identifieur interne : 006660 ( Istex/Corpus ); précédent : 006659; suivant : 006661Combined inguinal and pelvic lymph node dissection for stage III melanoma
Auteurs : T. M. D. Hughes ; T. M. D. ThomasSource :
- British Journal of Surgery [ 0007-1323 ] ; 1999-12-01.
Abstract
The incidence of melanoma is increasing in the UK and a significant number of patients are still presenting with primary lesions of poor prognosis. As a consequence there is likely to be an increasing number of patients with lymph node metastases for whom the appropriate extent of groin dissection remains controversial. This review summarizes the evidence to enable surgeons to make an informed decision about the management of patients with melanoma metastases to the groin lymph nodes.
Url:
DOI: 10.1046/j.1365-2168.1999.01316.x
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ISTEX:DB0C955F0E3DAB640E246EE469C3C963FC1D4367Le document en format XML
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Thomas</name><affiliation><mods:affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</mods:affiliation></affiliation><affiliation><mods:affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:DB0C955F0E3DAB640E246EE469C3C963FC1D4367</idno><date when="1999" year="1999">1999</date><idno type="doi">10.1046/j.1365-2168.1999.01316.x</idno><idno type="url">https://api.istex.fr/document/DB0C955F0E3DAB640E246EE469C3C963FC1D4367/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">006660</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">006660</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Combined inguinal and pelvic lymph node dissection for stage III melanoma</title><author><name sortKey="Hughes, T M D" sort="Hughes, T M D" uniqKey="Hughes T" first="T. M. D." last="Hughes">T. M. D. Hughes</name><affiliation><mods:affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</mods:affiliation></affiliation></author><author><name sortKey="Thomas, T M D" sort="Thomas, T M D" uniqKey="Thomas T" first="T. M. D." last="Thomas">T. M. D. Thomas</name><affiliation><mods:affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</mods:affiliation></affiliation><affiliation><mods:affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</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">86</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1493">1493</biblScope><biblScope unit="page" to="1498">1498</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Science Ltd.</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1999-12-01">1999-12-01</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 incidence of melanoma is increasing in the UK and a significant number of patients are still presenting with primary lesions of poor prognosis. As a consequence there is likely to be an increasing number of patients with lymph node metastases for whom the appropriate extent of groin dissection remains controversial. This review summarizes the evidence to enable surgeons to make an informed decision about the management of patients with melanoma metastases to the groin lymph nodes.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>node</json:string><json:string>melanoma</json:string><json:string>clnd</json:string><json:string>inguinal</json:string><json:string>surg</json:string><json:string>metastasis</json:string><json:string>slnd</json:string><json:string>lymphoedema</json:string><json:string>lymph</json:string><json:string>nodal</json:string><json:string>morbidity</json:string><json:string>plnd</json:string><json:string>elective</json:string><json:string>karakousis</json:string><json:string>coit</json:string><json:string>pelvic lymph node dissection</json:string><json:string>dissection</json:string><json:string>malignant melanoma</json:string><json:string>malignant</json:string><json:string>groin dissection</json:string><json:string>prognostic</json:string><json:string>pelvic</json:string><json:string>coit6</json:string><json:string>oncol</json:string><json:string>randomized</json:string><json:string>recurrence</json:string><json:string>inguinal lymph node dissection</json:string><json:string>blackwell science</json:string><json:string>prognostic factors</json:string><json:string>surg oncol</json:string><json:string>lymph node dissection</json:string><json:string>survival rate</json:string><json:string>inguinal nodes</json:string><json:string>british journal</json:string><json:string>appropriate management</json:string><json:string>positive nodes</json:string><json:string>inguinal lymph nodes</json:string><json:string>groin</json:string><json:string>groin recurrence</json:string><json:string>elective lymph node dissection</json:string><json:string>pelvic lymph nodes</json:string><json:string>cent chance</json:string><json:string>surgical management</json:string><json:string>pelvic lymph node involvement</json:string><json:string>lymph node metastases</json:string><json:string>pelvic nodes</json:string><json:string>lower extremity</json:string><json:string>arch surg</json:string><json:string>surg gynecol obstet</json:string><json:string>melanoma metastatic</json:string><json:string>lymph nodes</json:string></teeft></keywords><author><json:item><name>T. M. D. Hughes</name><affiliations><json:string>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</json:string></affiliations></json:item><json:item><name>Mr Thomas</name><affiliations><json:string>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</json:string><json:string>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</json:string></affiliations></json:item></author><articleId><json:string>BJS3</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>reviewArticle</json:string></originalGenre><qualityIndicators><score>4.945</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>489</abstractCharCount><pdfWordCount>4021</pdfWordCount><pdfCharCount>24807</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>77</abstractWordCount></qualityIndicators><title>Combined inguinal and pelvic lymph node dissection for stage III melanoma</title><genre><json:string>review-article</json:string></genre><host><title>British Journal of Surgery</title><language><json:string>unknown</json:string></language><doi><json:string>10.1002/(ISSN)1365-2168</json:string></doi><issn><json:string>0007-1323</json:string></issn><eissn><json:string>1365-2168</json:string></eissn><publisherId><json:string>BJS</json:string></publisherId><volume>86</volume><issue>12</issue><pages><first>1493</first><last>1498</last><total>6</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Review</value></json:item></subject></host><categories><wos><json:string>science</json:string><json:string>surgery</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>surgery</json:string></scienceMetrix></categories><publicationDate>1999</publicationDate><copyrightDate>1999</copyrightDate><doi><json:string>10.1046/j.1365-2168.1999.01316.x</json:string></doi><id>DB0C955F0E3DAB640E246EE469C3C963FC1D4367</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/DB0C955F0E3DAB640E246EE469C3C963FC1D4367/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/DB0C955F0E3DAB640E246EE469C3C963FC1D4367/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/DB0C955F0E3DAB640E246EE469C3C963FC1D4367/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Combined inguinal and pelvic lymph node dissection for stage III melanoma</title></titleStmt><publicationStmt><publisher>Blackwell Science Ltd.</publisher><pubPlace>Oxford, UK</pubPlace><availability><licence>© 1999 British Journal of Surgery Society Ltd</licence></availability><date type="published" when="1999-12-01"></date></publicationStmt><notesStmt><note type="content-type" subtype="review-article" source="reviewArticle" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-L5L7X3NF-P">review-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="review-article"><analytic><title level="a" type="main" xml:lang="en">Combined inguinal and pelvic lymph node dissection for stage III melanoma</title><title level="a" type="short" xml:lang="en">Inguinal and pelvic lymph node dissection for melanoma</title><author xml:id="author-0000"><persName><forename type="first">T. M. D.</forename><surname>Hughes</surname></persName><affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK<address><country key="GB"></country></address></affiliation></author><author xml:id="author-0001" role="corresp"><persName><addName>Mr</addName><forename type="first">J. M.</forename><surname>Thomas</surname></persName><affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK<address><country key="GB"></country></address></affiliation><affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</affiliation></author><idno type="istex">DB0C955F0E3DAB640E246EE469C3C963FC1D4367</idno><idno type="DOI">10.1046/j.1365-2168.1999.01316.x</idno><idno type="unit">BJS3</idno><idno type="editorialOffice">1316</idno><idno type="toTypesetVersion">file:BJS.BJS3.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.v86:12</idno><idno type="product">BJS</idno><imprint><biblScope unit="vol">86</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1493">1493</biblScope><biblScope unit="page" to="1498">1498</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Science Ltd.</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1999-12-01"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head>
Background:
<p>The incidence of melanoma is increasing in the UK and a significant number of patients are still presenting with primary lesions of poor prognosis. As a consequence there is likely to be an increasing number of patients with lymph node metastases for whom the appropriate extent of groin dissection remains controversial. This review summarizes the evidence to enable surgeons to make an informed decision about the management of patients with melanoma metastases to the groin lymph nodes.</p>
Methods:
<p>A Medline search was performed to identify all English language articles about melanoma containing the words lymphadenectomy, lymph nodes, inguinal or lymphoedema. Eighty‐seven relevant articles were selected from 3904 abstracts retrieved; 34 were related directly to the aim of this review.</p>
Results:
<p>There are no randomized controlled trials comparing the outcome of combined inguinal and pelvic lymph node dissection (CLND) and superficial inguinal lymph node dissection (SLND). Excision of pelvic lymph node metastases is reported to yield a 5‐year survival rate of 0–35 per cent. Recurrence within the pelvis occurs in 9–18 per cent of patients after SLND and in less than 5 per cent after CLND. Morbidity following either CLND or SLND is poorly reported. Major long‐term lymphoedema limiting patient activity affects 6–20 per cent of patients after groin dissection. Cloquet's node was demonstrated in one study to be a useful predictor of pelvic lymph node involvement. Patients may be selected for pelvic node dissection on the basis of clinical findings, the results of pelvic computed tomography and the status of Cloquet's node.</p>
Conclusion:
<p>The controversy surrounding the appropriate management of cytologically positive inguinal nodes in melanoma can be resolved only by a prospective randomized trial comparing CLND with SLND. Morbidity and local disease control must be measured as outcomes in addition to disease‐free and overall survival. © 1999 British Journal of Surgery Society Ltd</p></abstract><textClass><classCode scheme="articleCategory">Review</classCode><classCode scheme="tocHeading1">Reviews</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/DB0C955F0E3DAB640E246EE469C3C963FC1D4367/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>Blackwell Science Ltd.</publisherName><publisherLoc>Oxford, 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="120"><doi origin="wiley" registered="yes">10.1002/bjs.v86:12</doi><numberingGroup><numbering type="journalVolume" number="86">86</numbering><numbering type="journalIssue">12</numbering></numberingGroup><coverDate startDate="1999-12-01">1 December 1999</coverDate></publicationMeta><publicationMeta level="unit" type="reviewArticle" position="3" status="forIssue"><doi origin="wiley" registered="yes">10.1046/j.1365-2168.1999.01316.x</doi><idGroup><id type="unit" value="BJS3"></id><id type="editorialOffice" value="1316"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="articleCategory">Review</title><title type="tocHeading1">Reviews</title></titleGroup><copyright ownership="thirdParty">© 1999 British Journal of Surgery Society Ltd</copyright><eventGroup><event type="manuscriptAccepted" date="1999-08-31"></event><event type="firstOnline" date="2002-12-10"></event><event type="publishedOnlineFinalForm" date="2002-12-10"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.1 mode:FullText source:HeaderRef result:HeaderRef" date="2010-02-23"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-07"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-15"></event></eventGroup><numberingGroup><numbering type="pageFirst">1493</numbering><numbering type="pageLast">1498</numbering></numberingGroup><correspondenceTo>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:BJS.BJS3.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="34"></count></countGroup><titleGroup><title type="main" xml:lang="en">Combined inguinal and pelvic lymph node dissection for stage III melanoma</title><title type="short" xml:lang="en">Inguinal and pelvic lymph node dissection for melanoma</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>T. M. D.</givenNames><familyName>Hughes</familyName></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><honorifics>Mr</honorifics><givenNames>J. M.</givenNames><familyName>Thomas</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="GB" type="organization"><unparsedAffiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background:</title><p>The incidence of melanoma is increasing in the UK and a significant number of patients are still presenting with primary lesions of poor prognosis. As a consequence there is likely to be an increasing number of patients with lymph node metastases for whom the appropriate extent of groin dissection remains controversial. This review summarizes the evidence to enable surgeons to make an informed decision about the management of patients with melanoma metastases to the groin lymph nodes.</p></section><section xml:id="abs1-2"><title type="main">Methods:</title><p>A Medline search was performed to identify all English language articles about melanoma containing the words lymphadenectomy, lymph nodes, inguinal or lymphoedema. Eighty‐seven relevant articles were selected from 3904 abstracts retrieved; 34 were related directly to the aim of this review.</p></section><section xml:id="abs1-3"><title type="main">Results:</title><p>There are no randomized controlled trials comparing the outcome of combined inguinal and pelvic lymph node dissection (CLND) and superficial inguinal lymph node dissection (SLND). Excision of pelvic lymph node metastases is reported to yield a 5‐year survival rate of 0–35 per cent. Recurrence within the pelvis occurs in 9–18 per cent of patients after SLND and in less than 5 per cent after CLND. Morbidity following either CLND or SLND is poorly reported. Major long‐term lymphoedema limiting patient activity affects 6–20 per cent of patients after groin dissection. Cloquet's node was demonstrated in one study to be a useful predictor of pelvic lymph node involvement. Patients may be selected for pelvic node dissection on the basis of clinical findings, the results of pelvic computed tomography and the status of Cloquet's node.</p></section><section xml:id="abs1-4"><title type="main">Conclusion:</title><p>The controversy surrounding the appropriate management of cytologically positive inguinal nodes in melanoma can be resolved only by a prospective randomized trial comparing CLND with SLND. Morbidity and local disease control must be measured as outcomes in addition to disease‐free and overall survival. © 1999 British Journal of Surgery Society Ltd</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Combined inguinal and pelvic lymph node dissection for stage III melanoma</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Inguinal and pelvic lymph node dissection for melanoma</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Combined inguinal and pelvic lymph node dissection for stage III melanoma</title></titleInfo><name type="personal"><namePart type="given">T. M. D.</namePart><namePart type="family">Hughes</namePart><affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="termsOfAddress">Mr</namePart><namePart type="family">Thomas</namePart><affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</affiliation><affiliation>Melanoma and Sarcoma Unit, Royal Marsden Hospital NHS Trust, Fulham Road, London SW3 6JJ, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="reviewArticle"></genre><originInfo><publisher>Blackwell Science Ltd.</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">1999-12-01</dateIssued><dateValid encoding="w3cdtf">1999-08-31</dateValid><copyrightDate encoding="w3cdtf">1999</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">3</extent><extent unit="references">34</extent></physicalDescription><abstract>The incidence of melanoma is increasing in the UK and a significant number of patients are still presenting with primary lesions of poor prognosis. As a consequence there is likely to be an increasing number of patients with lymph node metastases for whom the appropriate extent of groin dissection remains controversial. This review summarizes the evidence to enable surgeons to make an informed decision about the management of patients with melanoma metastases to the groin lymph nodes.</abstract><abstract>A Medline search was performed to identify all English language articles about melanoma containing the words lymphadenectomy, lymph nodes, inguinal or lymphoedema. Eighty‐seven relevant articles were selected from 3904 abstracts retrieved; 34 were related directly to the aim of this review.</abstract><abstract>There are no randomized controlled trials comparing the outcome of combined inguinal and pelvic lymph node dissection (CLND) and superficial inguinal lymph node dissection (SLND). Excision of pelvic lymph node metastases is reported to yield a 5‐year survival rate of 0–35 per cent. Recurrence within the pelvis occurs in 9–18 per cent of patients after SLND and in less than 5 per cent after CLND. Morbidity following either CLND or SLND is poorly reported. Major long‐term lymphoedema limiting patient activity affects 6–20 per cent of patients after groin dissection. Cloquet's node was demonstrated in one study to be a useful predictor of pelvic lymph node involvement. Patients may be selected for pelvic node dissection on the basis of clinical findings, the results of pelvic computed tomography and the status of Cloquet's node.</abstract><abstract>The controversy surrounding the appropriate management of cytologically positive inguinal nodes in melanoma can be resolved only by a prospective randomized trial comparing CLND with SLND. 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