The impact of sentinel node dissection on disease‐free and overall tumour‐specific survival in melanoma patients: a single centre group‐matched analysis of 1192 patients

Geimer, Till; Sattler, Elke; Flaig, Michael J.; Ruzicka, Thomas; Berking, Carola; Schmid‐Wendtner, Monika‐Hildegard; Kunte, Christian

doi:10.1111/jdv.13939

Cited by 11 publications

(2 citation statements)

References 29 publications

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“…Although the role of SLNB as a prognostic factor is well established, its therapeutic significance is disputed. Some studies indicated that patients undergoing SLNB have a better prognosis compared with patients who do not, while others found no survival benefit for SLNB . Furthermore, the question, whether removing only the SLN is sufficient for disease control, is open.…”

Section: Discussionmentioning

confidence: 99%

Complete lymph node dissection or observation in melanoma patients with multiple positive sentinel lymph nodes: A single‐center retrospective analysis

Persa

Knuever

Mauch

et al. 2018

The Journal of Dermatology

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Although the role of sentinel lymph node biopsy (SLNB) as a prognostic factor is well established, its consequences for therapy are controversial. The aim of this study was to analyze if complete lymph node dissection (CLND) in patients with more than one positive sentinel lymph node (SLN) significantly improves melanoma-specific survival (MSS) and progression-free survival (PFS). Medical records of patients who underwent SLNB between 2001 and 2016 at the University Hospital of Cologne were reviewed, and patients with positive SLN were identified. Patient and tumor characteristics, patterns of recurrence, progression-free and melanoma-specific survival were analyzed. Seventy-eight patients with multiple positive and 197 patients with one positive SLN were included in this study. Patients with multiple positive SLN had significantly more positive non-SLN compared with patients with only one positive SLN (26.9% vs 8.6%, P = 0.01). However, in the subgroup of patients with multiple positive SLN, CLND did not significantly improve MSS (mean MSS 95 vs 75 months, P = 0.5) and PFS (mean PFS 59 vs 68 months P = 0.167). CLND did not result in a significant improvement in PFS and MSS in patients with multiple positive SLN.

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Section: Discussionmentioning

confidence: 99%

Complete lymph node dissection or observation in melanoma patients with multiple positive sentinel lymph nodes: A single‐center retrospective analysis

Persa

Knuever

Mauch

et al. 2018

The Journal of Dermatology

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“…Even though immediate completion lymph-node dissection has proved to be of value regarding staging and ameliorated rate of regional disease control, the high incidence of complications (24 vs 6% of lymphedema) is considered prohibitive taking into account the lack of survival benefit. Considering both MSLT-I and MSLT-II results, it seems fair to recognize some potential therapeutic value of the SNB procedure as increase in survival occurred exclusively among patients with disease limited to the SN [52]. On the other hand, patients with non-SN metastases can still undergo complete nodal basin dissection but not immediately after SNB; active surveillance of the nodal basin seems to be a safe and efficient way to identify patients who are most likely to benefit from delayed, selective, node-directed treatment [53].…”

Section: Lymphoscintigraphy Improves the Accuracy Of Sentinel Lymph Nmentioning

confidence: 99%

Melanoma & Nuclear Medicine: New Insights & Advances

et al. 2018

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The contribution of nuclear medicine to management of melanoma patients is increasing. In intermediate-thickness N0 melanomas, lymphoscintigraphy provides a roadmap for sentinel node biopsy. With the introduction of single-photon emission computed tomography images with integrated computed tomography (SPECT/CT), 3D anatomic environments for accurate surgical planning are now possible. Sentinel node identification in intricate anatomical areas (pelvic cavity, head/neck) has been improved using hybrid radioactive/fluorescent tracers, preoperative lymphoscintigraphy and SPECT/CT together with modern intraoperative portable imaging technologies for surgical navigation (free-hand SPECT, portable gamma cameras). Furthermore, PET/CT today provides 3D roadmaps to resect 18F-fluorodeoxyglucose-avid melanoma lesions. Simultaneously, in advanced-stage melanoma and recurrences, 18F-fluorodeoxyglucose-PET/CT is useful in clinical staging and treatment decision as well as in the evaluation of therapy response. In this article, we review new insights and recent nuclear medicine advances in the management of melanoma patients.

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Stellenwert der chirurgischen Metastasenentfernung bei Hautmelanomen im Stadium IV

Wollina

Brzeziński

2018

Wien Med Wochenschr

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Cutaneous melanoma is an aggressive neoplasia of melanocytes. Prognosis is dependent on tumor stage. Stage IV melanoma is characterized by the occurrence of distant metastases. Response of metastases to classical chemotherapy is limited and toxicity of treatment is high. In recent years, new developments in immunotherapy and targeted therapies improved prognosis of stage IV melanoma patients with better tolerability of treatment. There is no dispute about surgical treatment of primary melanoma. But what is the value of metastasectomy in the era of new systemic treatments? This review aims to discuss available data for surgical removal of distant metastases for several organs and tissues. The available evidence suggests that for selected patients with possible complete resection of all tumor metastases, metastasectomy remains an effective treatment option with a benefit in overall survival.

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The impact of sentinel node dissection on disease‐free and overall tumour‐specific survival in melanoma patients: a single centre group‐matched analysis of 1192 patients

Abstract: SLND is not only an important diagnostic procedure, but might also be of therapeutic benefit in terms of disease-free and overall tumour-specific survival of melanoma patients.

Cited by 11 publications

References 29 publications

Complete lymph node dissection or observation in melanoma patients with multiple positive sentinel lymph nodes: A single‐center retrospective analysis

Complete lymph node dissection or observation in melanoma patients with multiple positive sentinel lymph nodes: A single‐center retrospective analysis

Melanoma & Nuclear Medicine: New Insights & Advances

Stellenwert der chirurgischen Metastasenentfernung bei Hautmelanomen im Stadium IV

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