Abstract
Background: Completion lymph node dissection (CLND) for sentinel lymph node (SLN) disease in melanoma patients is debated. We evaluated the impact of CLND on survival and assessed for predictors of nonsentinel node metastasis (positive CLND). Methods: Positive SLN melanoma patients were retrospectively identified in the Sentinel Lymph Node Working Group database. Clinicopathological factors were correlated with CLND status, overall survival (OS), and melanoma-specific survival (MSS). Results: There were 953 positive SLN patients of whom 831 (87%) had CLND. Positive CLND was seen in 141 (17%) cases and was associated with worse OS and MSS (both P < 0.001). CLND was not performed (No-CLND) in 122 of 953 positive SLN cases (13%), of whom 100 had follow-up and 18 (18%) developed a nodal recurrence (NR). No significant differences in OS and MSS were seen comparing CLND with No-CLND (P = 0.084, P = 0.161, respectively) and comparing positive CLND with No-CLND NR patients (P = 0.565, P = 0.998, respectively). Gender, primary site, ulceration, and number of positive SLNs were correlated with nonsentinel node metastasis. Conclusions: Performance of CLND provides prognostic information but is not associated with a survival benefit. Clinical variables can predict a positive CLND in patients who may be at high risk of recurrence.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1053-1059 |
| Number of pages | 7 |
| Journal | Journal of Surgical Oncology |
| Volume | 119 |
| Issue number | 8 |
| DOIs | |
| State | Published - Jun 15 2019 |
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Keywords
- completion lymphadenectomy
- melanoma
- nonsentinel node metastasis
ASJC Scopus subject areas
- Surgery
- Oncology
Cite this
Completion lymphadenectomy for a positive sentinel node biopsy in melanoma patients is not associated with a survival benefit. / Klemen, Nicholas D.; Han, Gang; Leong, Stanley P.; Kashani-Sabet, Mohammed; Vetto, John; White, Richard; Schneebaum, Schlomo; Pockaj, Barbara A; Mozzillo, Nicola; Charney, Kim; Hoekstra, Harald; Sondak, Vernon K.; Messina, Jane L.; Zager, Jonathan S.; Han, Dale.
In: Journal of Surgical Oncology, Vol. 119, No. 8, 15.06.2019, p. 1053-1059.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Completion lymphadenectomy for a positive sentinel node biopsy in melanoma patients is not associated with a survival benefit
AU - Klemen, Nicholas D.
AU - Han, Gang
AU - Leong, Stanley P.
AU - Kashani-Sabet, Mohammed
AU - Vetto, John
AU - White, Richard
AU - Schneebaum, Schlomo
AU - Pockaj, Barbara A
AU - Mozzillo, Nicola
AU - Charney, Kim
AU - Hoekstra, Harald
AU - Sondak, Vernon K.
AU - Messina, Jane L.
AU - Zager, Jonathan S.
AU - Han, Dale
PY - 2019/6/15
Y1 - 2019/6/15
N2 - Background: Completion lymph node dissection (CLND) for sentinel lymph node (SLN) disease in melanoma patients is debated. We evaluated the impact of CLND on survival and assessed for predictors of nonsentinel node metastasis (positive CLND). Methods: Positive SLN melanoma patients were retrospectively identified in the Sentinel Lymph Node Working Group database. Clinicopathological factors were correlated with CLND status, overall survival (OS), and melanoma-specific survival (MSS). Results: There were 953 positive SLN patients of whom 831 (87%) had CLND. Positive CLND was seen in 141 (17%) cases and was associated with worse OS and MSS (both P < 0.001). CLND was not performed (No-CLND) in 122 of 953 positive SLN cases (13%), of whom 100 had follow-up and 18 (18%) developed a nodal recurrence (NR). No significant differences in OS and MSS were seen comparing CLND with No-CLND (P = 0.084, P = 0.161, respectively) and comparing positive CLND with No-CLND NR patients (P = 0.565, P = 0.998, respectively). Gender, primary site, ulceration, and number of positive SLNs were correlated with nonsentinel node metastasis. Conclusions: Performance of CLND provides prognostic information but is not associated with a survival benefit. Clinical variables can predict a positive CLND in patients who may be at high risk of recurrence.
AB - Background: Completion lymph node dissection (CLND) for sentinel lymph node (SLN) disease in melanoma patients is debated. We evaluated the impact of CLND on survival and assessed for predictors of nonsentinel node metastasis (positive CLND). Methods: Positive SLN melanoma patients were retrospectively identified in the Sentinel Lymph Node Working Group database. Clinicopathological factors were correlated with CLND status, overall survival (OS), and melanoma-specific survival (MSS). Results: There were 953 positive SLN patients of whom 831 (87%) had CLND. Positive CLND was seen in 141 (17%) cases and was associated with worse OS and MSS (both P < 0.001). CLND was not performed (No-CLND) in 122 of 953 positive SLN cases (13%), of whom 100 had follow-up and 18 (18%) developed a nodal recurrence (NR). No significant differences in OS and MSS were seen comparing CLND with No-CLND (P = 0.084, P = 0.161, respectively) and comparing positive CLND with No-CLND NR patients (P = 0.565, P = 0.998, respectively). Gender, primary site, ulceration, and number of positive SLNs were correlated with nonsentinel node metastasis. Conclusions: Performance of CLND provides prognostic information but is not associated with a survival benefit. Clinical variables can predict a positive CLND in patients who may be at high risk of recurrence.
KW - completion lymphadenectomy
KW - melanoma
KW - nonsentinel node metastasis
UR - http://www.scopus.com/inward/record.url?scp=85066107868&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85066107868&partnerID=8YFLogxK
U2 - 10.1002/jso.25444
DO - 10.1002/jso.25444
M3 - Article
VL - 119
SP - 1053
EP - 1059
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
SN - 0022-4790
IS - 8
ER -