Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors
Identifieur interne : 001F53 ( Pmc/Checkpoint ); précédent : 001F52; suivant : 001F54Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors
Auteurs : Nicola Mozzillo [Italie] ; Corrado Carac [Italie] ; Ugo Marone [Italie] ; Gianluca Di Monta [Italie] ; Anna Crispo [Italie] ; Gerardo Botti [Italie] ; Maurizio Montella [Italie] ; Paolo Antonio Ascierto [Italie]Source :
- World Journal of Surgical Oncology [ 1477-7819 ] ; 2013.
Abstract
The aims of this retrospective analysis were to evaluate the effect of combined superficial and deep groin dissection on disease-free and melanoma-specific survival, and to identify the most important factors for predicting the involvement of deep nodes according to clinically or microscopically detected nodal metastases.
Between January 1996 and December 2005, 133 consecutive patients with groin lymph node metastases underwent superficial and deep dissection at the National Cancer Institute, Naples. Lymph node involvement was clinically evident in 84 patients and detected by sentinel node biopsy in 49 cases.
The 5-year disease-free survival was significantly better for patients with superficial lymph node metastases than for patients with involvement of both superficial and deep lymph nodes (34.9% vs. 19.0%;
Metastasis in the deep nodes is the strongest predictor of both disease-free and melanoma-specific survival. Deep groin dissection should be considered for all patients with groin clinical nodal involvement, but might be spared in patients with a positive sentinel node. Prospective studies will clarify the issue further.
Url:
DOI: 10.1186/1477-7819-11-36
PubMed: 23379355
PubMed Central: 3585715
Affiliations:
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<series><title level="j">World Journal of Surgical Oncology</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The aims of this retrospective analysis were to evaluate the effect of combined superficial and deep groin dissection on disease-free and melanoma-specific survival, and to identify the most important factors for predicting the involvement of deep nodes according to clinically or microscopically detected nodal metastases.</p>
</sec>
<sec><title>Methods</title>
<p>Between January 1996 and December 2005, 133 consecutive patients with groin lymph node metastases underwent superficial and deep dissection at the National Cancer Institute, Naples. Lymph node involvement was clinically evident in 84 patients and detected by sentinel node biopsy in 49 cases.</p>
</sec>
<sec><title>Results</title>
<p>The 5-year disease-free survival was significantly better for patients with superficial lymph node metastases than for patients with involvement of both superficial and deep lymph nodes (34.9% vs. 19.0%; <italic>P</italic>
= 0.001). The 5-year melanoma-specific survival was also significantly better for patients with superficial node metastases only (55.6% vs. 33.3%; <italic>P</italic>
= 0.001).</p>
</sec>
<sec><title>Conclusions</title>
<p>Metastasis in the deep nodes is the strongest predictor of both disease-free and melanoma-specific survival. Deep groin dissection should be considered for all patients with groin clinical nodal involvement, but might be spared in patients with a positive sentinel node. Prospective studies will clarify the issue further.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">World J Surg Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">World J Surg Oncol</journal-id>
<journal-title-group><journal-title>World Journal of Surgical Oncology</journal-title>
</journal-title-group>
<issn pub-type="epub">1477-7819</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23379355</article-id>
<article-id pub-id-type="pmc">3585715</article-id>
<article-id pub-id-type="publisher-id">1477-7819-11-36</article-id>
<article-id pub-id-type="doi">10.1186/1477-7819-11-36</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" id="A1"><name><surname>Mozzillo</surname>
<given-names>Nicola</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>nimozzi@tin.it</email>
</contrib>
<contrib contrib-type="author" corresp="yes" id="A2"><name><surname>Caracò</surname>
<given-names>Corrado</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>corracara@fastwebnet.it</email>
</contrib>
<contrib contrib-type="author" id="A3"><name><surname>Marone</surname>
<given-names>Ugo</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>dott.marone@libero.it</email>
</contrib>
<contrib contrib-type="author" id="A4"><name><surname>Di Monta</surname>
<given-names>Gianluca</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>gidimonta@libero.it</email>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>Crispo</surname>
<given-names>Anna</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>anna.crispo@istitutotumori.na.it</email>
</contrib>
<contrib contrib-type="author" id="A6"><name><surname>Botti</surname>
<given-names>Gerardo</given-names>
</name>
<xref ref-type="aff" rid="I5">5</xref>
<email>g.botti@istitutotumori.na.it</email>
</contrib>
<contrib contrib-type="author" id="A7"><name><surname>Montella</surname>
<given-names>Maurizio</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>maurizio.monyella@istitutotumori.na.it</email>
</contrib>
<contrib contrib-type="author" id="A8"><name><surname>Ascierto</surname>
<given-names>Paolo Antonio</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>pasciert@tin.it</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
Department of Melanoma, Sarcoma and Skin Cancer, Via Mariano Semmola, Naples, 80131, Italy</aff>
<aff id="I2"><label>2</label>
Division of Melanoma and Skin Cancer, Via Mariano Semmola, Naples, 80131, Italy</aff>
<aff id="I3"><label>3</label>
Division of Oncology, Via Mariano Semmola, Naples, 80131, Italy</aff>
<aff id="I4"><label>4</label>
Division of Epidemiology, Via Mariano Semmola, Naples, 80131, Italy</aff>
<aff id="I5"><label>5</label>
Division of Pathology, Via Mariano Semmola, Naples, 80131, Italy</aff>
<pub-date pub-type="collection"><year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>4</day>
<month>2</month>
<year>2013</year>
</pub-date>
<volume>11</volume>
<fpage>36</fpage>
<lpage>36</lpage>
<history><date date-type="received"><day>26</day>
<month>9</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>6</day>
<month>1</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>Copyright ©2013 Mozzillo et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2013</copyright-year>
<copyright-holder>Mozzillo et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.wjso.com/content/11/1/36"></self-uri>
<abstract><sec><title>Background</title>
<p>The aims of this retrospective analysis were to evaluate the effect of combined superficial and deep groin dissection on disease-free and melanoma-specific survival, and to identify the most important factors for predicting the involvement of deep nodes according to clinically or microscopically detected nodal metastases.</p>
</sec>
<sec><title>Methods</title>
<p>Between January 1996 and December 2005, 133 consecutive patients with groin lymph node metastases underwent superficial and deep dissection at the National Cancer Institute, Naples. Lymph node involvement was clinically evident in 84 patients and detected by sentinel node biopsy in 49 cases.</p>
</sec>
<sec><title>Results</title>
<p>The 5-year disease-free survival was significantly better for patients with superficial lymph node metastases than for patients with involvement of both superficial and deep lymph nodes (34.9% vs. 19.0%; <italic>P</italic>
= 0.001). The 5-year melanoma-specific survival was also significantly better for patients with superficial node metastases only (55.6% vs. 33.3%; <italic>P</italic>
= 0.001).</p>
</sec>
<sec><title>Conclusions</title>
<p>Metastasis in the deep nodes is the strongest predictor of both disease-free and melanoma-specific survival. Deep groin dissection should be considered for all patients with groin clinical nodal involvement, but might be spared in patients with a positive sentinel node. Prospective studies will clarify the issue further.</p>
</sec>
</abstract>
<kwd-group><kwd>Cutaneous melanoma</kwd>
<kwd>Sentinel biopsy</kwd>
<kwd>Lymph node metastases</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Italie</li>
</country>
</list>
<tree><country name="Italie"><noRegion><name sortKey="Mozzillo, Nicola" sort="Mozzillo, Nicola" uniqKey="Mozzillo N" first="Nicola" last="Mozzillo">Nicola Mozzillo</name>
</noRegion>
<name sortKey="Ascierto, Paolo Antonio" sort="Ascierto, Paolo Antonio" uniqKey="Ascierto P" first="Paolo Antonio" last="Ascierto">Paolo Antonio Ascierto</name>
<name sortKey="Botti, Gerardo" sort="Botti, Gerardo" uniqKey="Botti G" first="Gerardo" last="Botti">Gerardo Botti</name>
<name sortKey="Carac, Corrado" sort="Carac, Corrado" uniqKey="Carac C" first="Corrado" last="Carac">Corrado Carac</name>
<name sortKey="Crispo, Anna" sort="Crispo, Anna" uniqKey="Crispo A" first="Anna" last="Crispo">Anna Crispo</name>
<name sortKey="Di Monta, Gianluca" sort="Di Monta, Gianluca" uniqKey="Di Monta G" first="Gianluca" last="Di Monta">Gianluca Di Monta</name>
<name sortKey="Marone, Ugo" sort="Marone, Ugo" uniqKey="Marone U" first="Ugo" last="Marone">Ugo Marone</name>
<name sortKey="Montella, Maurizio" sort="Montella, Maurizio" uniqKey="Montella M" first="Maurizio" last="Montella">Maurizio Montella</name>
</country>
</tree>
</affiliations>
</record>
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