Is therapeutic lymph node dissection of value for lymph node recurrence in melanoma?
Publication Title
American journal of surgery
Document Type
Article
Publication Date
10-17-2023
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.
Area of Special Interest
Cancer
Specialty/Research Institute
Oncology
Specialty/Research Institute
Dermatology
Specialty/Research Institute
Surgery
DOI
10.1016/j.amjsurg.2023.10.035
