LymphedemaV1, Main, Exploration, bibRecord, 005722

Outcome of Patients with a Positive Sentinel Lymph Node who do not Undergo Completion Lymphadenectomy

Identifieur interne : 005722 ( Main/Exploration ); précédent : 005721; suivant : 005723

Outcome of Patients with a Positive Sentinel Lymph Node who do not Undergo Completion Lymphadenectomy

Auteurs : T. Peter Kingham [États-Unis] ; Katherine S. Panageas [États-Unis] ; Charlotte E. Ariyan [États-Unis] ; Klaus J. Busam [États-Unis] ; Mary Sue Brady [États-Unis] ; Daniel G. Coit [États-Unis]

Source :

Annals of surgical oncology [ 1068-9265 ] ; 2010.

RBID : PMC:4581428

Abstract

Background

Completion lymph node dissection (CLND), although considered a standard approach for patients with melanoma and a positive sentinel lymph node (SLN), is not performed in as many as 50% of indicated cases. This study evaluates the outcome of patients who had a positive SLN but did not undergo CLND at Memorial Sloan-Kettering Cancer Center.

Methods

A prospective database was used to identify all patients with a positive SLN from 1992 to 2008. Patient and tumor characteristics, number of positive SLNs, recurrence pattern, reason for not performing a CLND, and current status were evaluated.

Results

There were 2269 patients who underwent SLN biopsy. Three hundred thirteen had a positive SLN, of whom 271 (87%) had a CLND and 42 (13%) did not. Patients in the no-CLND group were older (median age 70 vs. 56 years, P < .01), and had a trend toward thicker melanomas (3.5 vs. 2.8 mm, P < .06). A significantly higher percentage of no- CLND patients had lower-extremity melanomas (40% vs. 13% CLND; P < .01). The most common reason for not performing a CLND was patient refusal (45%). There were similar rates and patterns of recurrence between the two groups. Recurrence-free survival and disease-specific survival were also similar between the groups.

Conclusions

It remains unclear whether CLND must be performed in all melanoma patients with a positive SLN. For selected informed patients who choose not to participate in the Multicenter Selective Lymphadenectomy Trial II trial, or in centers where the trial is not available, nodal observation may be an acceptable option.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581428

DOI: 10.1245/s10434-009-0836-3
PubMed: 19924486
PubMed Central: 4581428

Affiliations:

Le document en format XML

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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Completion lymph node dissection (CLND), although considered a standard approach for patients with melanoma and a positive sentinel lymph node (SLN), is not performed in as many as 50% of indicated cases. This study evaluates the outcome of patients who had a positive SLN but did not undergo CLND at Memorial Sloan-Kettering Cancer Center.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">A prospective database was used to identify all patients with a positive SLN from 1992 to 2008. Patient and tumor characteristics, number of positive SLNs, recurrence pattern, reason for not performing a CLND, and current status were evaluated.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">There were 2269 patients who underwent SLN biopsy. Three hundred thirteen had a positive SLN, of whom 271 (87%) had a CLND and 42 (13%) did not. Patients in the no-CLND group were older (median age 70 vs. 56 years, <italic>P</italic>
 < .01), and had a trend toward thicker melanomas (3.5 vs. 2.8 mm, <italic>P</italic>
 < .06). A significantly higher percentage of no- CLND patients had lower-extremity melanomas (40% vs. 13% CLND; <italic>P</italic>
 < .01). The most common reason for not performing a CLND was patient refusal (45%). There were similar rates and patterns of recurrence between the two groups. Recurrence-free survival and disease-specific survival were also similar between the groups.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">It remains unclear whether CLND must be performed in all melanoma patients with a positive SLN. For selected informed patients who choose not to participate in the Multicenter Selective Lymphadenectomy Trial II trial, or in centers where the trial is not available, nodal observation may be an acceptable option.</p>
</sec>
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<name sortKey="Ariyan, Charlotte E" sort="Ariyan, Charlotte E" uniqKey="Ariyan C" first="Charlotte E." last="Ariyan">Charlotte E. Ariyan</name>
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<name sortKey="Busam, Klaus J" sort="Busam, Klaus J" uniqKey="Busam K" first="Klaus J." last="Busam">Klaus J. Busam</name>
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Serveur d'exploration sur le lymphœdème

Outcome of Patients with a Positive Sentinel Lymph Node who do not Undergo Completion Lymphadenectomy

Outcome of Patients with a Positive Sentinel Lymph Node who do not Undergo Completion Lymphadenectomy

Source :

Abstract

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	Serveur d'exploration sur le lymphœdème
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