Limiting the morbidity of inguinal lymphadenectomy for metastatic melanoma.
Identifieur interne : 002E19 ( PubMed/Curation ); précédent : 002E18; suivant : 002E20Limiting the morbidity of inguinal lymphadenectomy for metastatic melanoma.
Auteurs : Amod A. Sarnaik [États-Unis] ; Christopher A. Puleo ; Jonathan S. Zager ; Vernon K. SondakSource :
- Cancer control : journal of the Moffitt Cancer Center [ 1526-2359 ] ; 2009.
Descripteurs français
- KwdFr :
- Biopsie de noeud lymphatique sentinelle, Canal inguinal, Complications postopératoires, Humains, Lymphadénectomie (), Lymphadénectomie (effets indésirables), Morbidité, Mélanome (), Mélanome (secondaire), Métastase lymphatique, Résultat thérapeutique, Tumeurs cutanées (), Tumeurs cutanées (anatomopathologie).
- MESH :
- anatomopathologie : Tumeurs cutanées.
- effets indésirables : Lymphadénectomie.
- secondaire : Mélanome.
- Biopsie de noeud lymphatique sentinelle, Canal inguinal, Complications postopératoires, Humains, Lymphadénectomie, Morbidité, Mélanome, Métastase lymphatique, Résultat thérapeutique, Tumeurs cutanées.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Lymph Node Excision.
- methods : Lymph Node Excision.
- pathology : Skin Neoplasms.
- secondary : Melanoma.
- surgery : Melanoma, Skin Neoplasms.
- Humans, Inguinal Canal, Lymphatic Metastasis, Morbidity, Postoperative Complications, Sentinel Lymph Node Biopsy, Treatment Outcome.
Abstract
Surgery is currently the primary treatment modality for metastatic melanoma involving the inguinal lymph nodes. However, inguinal lymph node dissections are associated with substantial morbidity including infection, wound dehiscence, lymphedema, seroma, and deep venous thromboembolism (DVT). Improved understanding is needed regarding the factors predisposing patients to complications and the operative and perioperative maneuvers that can decrease morbidity.
PubMed: 19556964
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<author><name sortKey="Sarnaik, Amod A" sort="Sarnaik, Amod A" uniqKey="Sarnaik A" first="Amod A" last="Sarnaik">Amod A. Sarnaik</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612</wicri:regionArea>
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<author><name sortKey="Puleo, Christopher A" sort="Puleo, Christopher A" uniqKey="Puleo C" first="Christopher A" last="Puleo">Christopher A. Puleo</name>
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<author><name sortKey="Zager, Jonathan S" sort="Zager, Jonathan S" uniqKey="Zager J" first="Jonathan S" last="Zager">Jonathan S. Zager</name>
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<author><name sortKey="Sondak, Vernon K" sort="Sondak, Vernon K" uniqKey="Sondak V" first="Vernon K" last="Sondak">Vernon K. Sondak</name>
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<series><title level="j">Cancer control : journal of the Moffitt Cancer Center</title>
<idno type="eISSN">1526-2359</idno>
<imprint><date when="2009" type="published">2009</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Humans</term>
<term>Inguinal Canal</term>
<term>Lymph Node Excision (adverse effects)</term>
<term>Lymph Node Excision (methods)</term>
<term>Lymphatic Metastasis</term>
<term>Melanoma (secondary)</term>
<term>Melanoma (surgery)</term>
<term>Morbidity</term>
<term>Postoperative Complications</term>
<term>Sentinel Lymph Node Biopsy</term>
<term>Skin Neoplasms (pathology)</term>
<term>Skin Neoplasms (surgery)</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Biopsie de noeud lymphatique sentinelle</term>
<term>Canal inguinal</term>
<term>Complications postopératoires</term>
<term>Humains</term>
<term>Lymphadénectomie ()</term>
<term>Lymphadénectomie (effets indésirables)</term>
<term>Morbidité</term>
<term>Mélanome ()</term>
<term>Mélanome (secondaire)</term>
<term>Métastase lymphatique</term>
<term>Résultat thérapeutique</term>
<term>Tumeurs cutanées ()</term>
<term>Tumeurs cutanées (anatomopathologie)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs cutanées</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lymph Node Excision</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Skin Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="secondaire" xml:lang="fr"><term>Mélanome</term>
</keywords>
<keywords scheme="MESH" qualifier="secondary" xml:lang="en"><term>Melanoma</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Melanoma</term>
<term>Skin Neoplasms</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Humans</term>
<term>Inguinal Canal</term>
<term>Lymphatic Metastasis</term>
<term>Morbidity</term>
<term>Postoperative Complications</term>
<term>Sentinel Lymph Node Biopsy</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Biopsie de noeud lymphatique sentinelle</term>
<term>Canal inguinal</term>
<term>Complications postopératoires</term>
<term>Humains</term>
<term>Lymphadénectomie</term>
<term>Morbidité</term>
<term>Mélanome</term>
<term>Métastase lymphatique</term>
<term>Résultat thérapeutique</term>
<term>Tumeurs cutanées</term>
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<front><div type="abstract" xml:lang="en">Surgery is currently the primary treatment modality for metastatic melanoma involving the inguinal lymph nodes. However, inguinal lymph node dissections are associated with substantial morbidity including infection, wound dehiscence, lymphedema, seroma, and deep venous thromboembolism (DVT). Improved understanding is needed regarding the factors predisposing patients to complications and the operative and perioperative maneuvers that can decrease morbidity.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">19556964</PMID>
<DateCreated><Year>2009</Year>
<Month>06</Month>
<Day>26</Day>
</DateCreated>
<DateCompleted><Year>2009</Year>
<Month>08</Month>
<Day>27</Day>
</DateCompleted>
<DateRevised><Year>2009</Year>
<Month>06</Month>
<Day>26</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1526-2359</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>16</Volume>
<Issue>3</Issue>
<PubDate><Year>2009</Year>
<Month>Jul</Month>
</PubDate>
</JournalIssue>
<Title>Cancer control : journal of the Moffitt Cancer Center</Title>
<ISOAbbreviation>Cancer Control</ISOAbbreviation>
</Journal>
<ArticleTitle>Limiting the morbidity of inguinal lymphadenectomy for metastatic melanoma.</ArticleTitle>
<Pagination><MedlinePgn>240-7</MedlinePgn>
</Pagination>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Surgery is currently the primary treatment modality for metastatic melanoma involving the inguinal lymph nodes. However, inguinal lymph node dissections are associated with substantial morbidity including infection, wound dehiscence, lymphedema, seroma, and deep venous thromboembolism (DVT). Improved understanding is needed regarding the factors predisposing patients to complications and the operative and perioperative maneuvers that can decrease morbidity.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We reviewed recently published literature regarding the morbidity associated with lymphadenectomy in the treatment of inguinal metastatic melanoma. Where available, emphasis was focused on appropriately designed studies aimed at reducing treatment-related morbidity. When appropriate, the review was supplemented by our personal experience.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Strategies to limit treatment-related morbidity involve optimizing the preoperative assessment, operative technique, and postoperative care. Establishing the diagnosis of nodal metastasis early using minimally invasive techniques is critical to reduce subsequent perioperative complications. Morbidity is higher for inguinal compared to cervical or axillary lymphadenectomy, and many variations in extent of inguinal lymphadenectomy and operative technique have been reported. The lack of definitive trials has led to controversy regarding surgical technique such as indications for pelvic lymphadenectomy ("deep" node dissection), saphenous vein preservation, and sartorius transposition. In the postoperative period, the use of DVT and lymphedema prophylaxis should be considered to potentially improve patient outcomes.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">While the morbidity of inguinal lymphadenectomy can be substantial, several straightforward pre- and postoperative measures can be instituted to limit morbidity. Controversy persists regarding the indications for and benefit of pelvic lymphadenectomy, saphenous vein preservation, and sartorius muscle transposition. A multi-institutional trial is currently in progress to investigate the safety of avoiding lymphadenectomy in patients with microscopic metastases in the sentinel node.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sarnaik</LastName>
<ForeName>Amod A</ForeName>
<Initials>AA</Initials>
<AffiliationInfo><Affiliation>Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Puleo</LastName>
<ForeName>Christopher A</ForeName>
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</Author>
<Author ValidYN="Y"><LastName>Zager</LastName>
<ForeName>Jonathan S</ForeName>
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</Author>
<Author ValidYN="Y"><LastName>Sondak</LastName>
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<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
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<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Cancer Control</MedlineTA>
<NlmUniqueID>9438457</NlmUniqueID>
<ISSNLinking>1073-2748</ISSNLinking>
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<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007264" MajorTopicYN="N">Inguinal Canal</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008207" MajorTopicYN="N">Lymphatic Metastasis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008545" MajorTopicYN="N">Melanoma</DescriptorName>
<QualifierName UI="Q000556" MajorTopicYN="N">secondary</QualifierName>
<QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009017" MajorTopicYN="N">Morbidity</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D021701" MajorTopicYN="N">Sentinel Lymph Node Biopsy</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012878" MajorTopicYN="N">Skin Neoplasms</DescriptorName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
<QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<NumberOfReferences>15</NumberOfReferences>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2009</Year>
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