Age-Related Lymphatic Dysfunction in Melanoma Patients

Conway, William G.; Faries, Mark B.; Nicholl, Michael B.; Terando, Alicia M.; Glass, Edwin C.; Sim, Myung‐Shin; Morton, Donald L.

doi:10.1245/s10434-009-0420-x

Cited by 98 publications

(72 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Slow lymphatic flow is observed in older patients (>50 years). In extremity melanoma, passive exercise of the limb may be helpful [91]. In some cases, repeated imaging (delayed images up to 24 h) or reinjection of radiotracer, if there is any suspicion of false injection, may also be helpful.…”

Section: Pitfallsmentioning

confidence: 99%

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

Bluemel

Herrmann

Giammarile

et al. 2015

Eur J Nucl Med Mol Imaging

115

131

View full text Add to dashboard Cite

show abstract

Section: Pitfallsmentioning

confidence: 99%

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

Bluemel

Herrmann

Giammarile

et al. 2015

Eur J Nucl Med Mol Imaging

115

131

View full text Add to dashboard Cite

show abstract

“…This last factor may be another possible explanation for the increase in tumor-positive SLNs because the older patients have altered lymphatic function. 13 This 'lymphatic dysfunction' may modify metastatic patterns and can possibly play a role in the reduced nodal positivity rate in the elderly.…”

Section: Tumor Metastases In the Slnmentioning

confidence: 99%

Long-term follow-up reveals that ulceration and sentinel lymph node status are the strongest predictors for survival in patients with primary cutaneous melanoma

Vries¹,

Speijers²,

Bastiaannet³

et al. 2011

European Journal of Surgical Oncology (EJSO)

View full text Add to dashboard Cite

, et al.. Long-term followup reveals that ulceration and sentinel lymph node status are the strongest predictors for survival in patients with primary cutaneous melanoma. EJSO -European Journal of Surgical Oncology, WB Saunders, 2011, 37 (8) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. 124 Patients (29%) relapsed during follow-up; 55 in the node-positive group who underwent CLND (55/119;46%) and 69 in the node-negative group (69/310;22%;p<0.001). In the node-negative group 17 patients developed recurrence in the regional node field; false-negative rate 11%.On multivariate analysis strongest prognostic factors for disease free survival (DFS) were primary melanoma ulceration and SLN positivity (Hazard Ratio (HR) of 2.2 and 2.3; p<0.001). For disease specific survival (DSS) the same was found to be true with a HR of 2.1 for ulceration and 2.0 for SLN positivity (p=0.001 and p=0.002 respectively). 10-Year DFS was 71% for node-negative patients compared with 48% for node-positive patients (p<0.001). 10-Year DSS was 77% for node-negative patients compared to 60% for node-positive patients (p<0.001).Conclusions: This study shows a remarkably high percentage of tumor-positive SLN. The long-term follow-up data confirm that tumor-positive SLN patients have a worse DFS and DSS than tumornegative SLN patients. Ulceration and SLN status proved to be the strongest prognostic factors for long-term DFS and DSS.

show abstract

“…Other possible explanations for poorer survival among older melanoma patients include more aggressive tumor biology (including increased incidence of acral lentiginous and desmoplastic melanomas), different mechanisms or ease of metastatic spread (including lymphatic dysfunction), limited physiologic reserve, poorer access to care, and under treatment by physicians. 7,8 Frailty in the elderly is associated with several adverse outcomes including increased risk of hospitalization, falls, impaired mobility, and disability. Frailty develops slowly and has many components including weight loss, weakness, poor endurance, slowness, and low physical activity.…”

mentioning

confidence: 99%