Optimal extent of completion lymphadenectomy for patients with melanoma and a positive sentinel node in the groin. BJS 2018; 105: 96-105.
Published: 2nd November 2017
Authors: D. Verver, M. F. Madu, C. M. C. Oude Ophuis, M. Faut, J. H. W. de Wilt, J. J. Bonenkamp et al.
The optimal extent of groin completion lymph node dissection (CLND) (inguinal or ilioinguinal dissection) in patients with melanoma is controversial. The aim of this study was to evaluate whether the extent of groin CLND after a positive sentinel node biopsy (SNB) is associated with improved outcome.
Data from all sentinel node‐positive patients who underwent groin CLND at four tertiary melanoma referral centres were retrieved retrospectively. Baseline patient and tumour characteristics were collected for descriptive statistics, survival analyses and Cox proportional hazards regression analyses.
In total, 255 patients were included, of whom 137 (53·7 per cent) underwent inguinal dissection and 118 (46·3 per cent) ilioinguinal dissection. The overall CLND positivity rate was 18·8 per cent; the inguinal positivity rate was 15·5 per cent and the pelvic positivity rate was 9·3 per cent. The pattern of recurrence, and 5‐year melanoma‐specific survival, disease‐free survival and distant‐metastasis free survival rates were similar for both dissection types, even for patients with a positive CLND result. Cox regression analysis showed that type of CLND was not associated with disease‐free or melanoma‐specific survival.
There was no significant difference in recurrence pattern and survival rates between patients undergoing inguinal or ilioinguinal dissection after a positive SNB, even after stratification for a positive CLND result. An inguinal dissection is a safe first approach as CLND in patients with a positive SNB.Full text
You may also be interested in
Meta‐analysis of in‐hospital delay before surgery as a risk factor for complications in patients with acute appendicitis. BJS 2018; 105: 933-945.
Authors: S. T. van Dijk, A. H. van Dijk, M. G. Dijkgraaf, M. A. Boermeester
Notes: Delay is safe
Authors: T. G. Weiser, A. B. Haynes
Meta‐analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer. BJS 2018; 105: 946-958.
Authors: E. Versteijne, J. A. Vogel, M. G. Besselink, O. R. C. Busch, J. W. Wilmink, J. G. Daams et al.
Notes: Improved survival with neoadjuvant treatment
Meta‐analysis evaluating music interventions for anxiety and pain in surgery. BJS 2018; 105: 773-783.
Authors: A. Y. R. Kühlmann, A. de Rooij, L. F. Kroese, M. van Dijk, M. G. M. Hunink, J. Jeekel et al.
Prognostic significance of gross extrathyroidal extension invading only strap muscles in differentiated thyroid carcinoma.
Authors: S. Y. Park, H. I. Kim, J.‐H. Kim, J. S. Kim, Y. L. Oh, S. W. Kim et al.
Notes: None for survival
Authors: M. Almquist, K. Ivarsson, E. Nordenström, A. Bergenfelz
Notes: Higher than expected
Authors: F. P. Prete, T. Abdel‐Aziz, C. Morkane, C. Brain, T. R. Kurzawinski, P. Hindmarsh et al.
Notes: Centralization needed
Authors: M. Mansourati, V. Kumar, M. Khajanchi, M. L. Saha, S. Dharap, R. Seger et al.
Notes: High burden of late mortality
Interobserver variability in the classification of appendicitis during laparoscopy. BJS 2018; 105: 1014-1019.
Authors: A. L. van den Boom, E. M. L. de Wijkerslooth, K. A. L. Mauff, I. Dawson, C. C. van Rossem, B. R. Toorenvliet et al.
Development and evaluation of a patient‐centred measurement tool for surgeons’ non‐technical skills. BJS 2018; 105: 876-884.
Authors: J. Yule, K. Hill, S. Yule
Notes: Valid and reliable