Is therapeutic lymph node dissection of value for lymph node recurrence in melanoma?

Document Type

Article

Publication Date

10-17-2023

Publication Title

American journal of surgery

Keywords

Distant metastasis-free survival; Melanoma-specific survival; Nodal recurrence; Recurrence; Sentinel lymph node; Therapeutic lymph node dissection.; california; sjci; santa monica

Abstract

BACKGROUND: Therapeutic lymphadenectomy (TLND) is still performed in most melanoma patients to treat nodal recurrences after initial negative lymph node biopsy (-SLNB), despite the lack of evidence for survival benefit. We sought to compare melanoma-specific survival (MSS) and distant metastasis-free survival (DMFS) of patients who underwent TLND versus no TLND using our institutional and MSTL-1 databases.

METHODS: We identified 146 patients with nodal recurrence following -SLNB: 132 underwent TLND and 14 did not. DMFS and MSS were evaluated for the cohorts followed by a matched-pair analysis between the cohorts.

RESULTS: No difference was observed in five-year DMFS (p = 0.454) and five-year MSS (p = 0.945) between the two groups. The matched-pair analysis showed similar results (p = 0.329 and p = 0.363 for DMSF and MSS, respectively).

CONCLUSIONS: From this limited retrospective study, TLND for nodal recurrence after a -SLNB does not appear to improve DMFS or MSS in melanoma patients compared to no TLND.

Clinical Institute

Cancer

Department

Oncology

Department

Dermatology

Department

Surgery

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