Complications following completion lymphadenectomy versus therapeutic lymphadenectomy for melanoma – A systematic review of the literature

Moody, J.A.; Botham, S.J.; Dahill, Katherine Elizabeth; Wallace, David; Hardwicke, Joseph

doi:10.1016/j.ejso.2017.07.003

Cited by 53 publications

(28 citation statements)

References 35 publications

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“…Postoperative infections account for around one out of four complications associated with hospitalrelated health care procedures, and can impair patient prognosis (17). Beyond clinical importance, a low infection rate can also have an economic impact, since the management of hospital-related infections requires about 0.8% of gross domestic product (GDP) in Italy (18).…”

Section: Surgicalmentioning

confidence: 99%

The Surgical Treatment of Non-Metastatic Melanoma in a Multicenter Registry: A Retrospective Cohort Quality Improvement Study to Reduce the Morbidity Rates

Fiore¹,

Mocellin²,

Rastrelli³

et al. 2020

Preprint

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Background: Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an Italian registry.Methods: Data were extracted from the Central National Melanoma Registry (CNMR) promoted by the Italian Melanoma Intergroup (IMI). All surgical procedures (WE, SNLB or LFND) for non-metastatic skin melanoma between January 2011 and February 2017 were evaluated for inclusion in the study. Only centers with adequate completeness of information (>80%) were included in the study. Short-term complications (wound infection, dehiscence, skin graft failure and seroma) were investigated.Results: Wound infection rate was 1.1% (0.4% to 2.7%) in WE, 1.3% (0.7% to 2.5%) in SLNB and 4.1% (2.1% to 8.0%) in LFND. Wound dehiscence rate was 2.0% (0.8% to 5.1%) in WE, 0.9% (0.2% to 3.0%) in SLNB and 2.8% (0.9% to 8.6%) in LFND. Seroma rate was 4.2% (1.5% to 11.1%) in SLNB and 15.1% (4.6% to 39.9%) in LFND. Unreliable information was found on skin graft failure.Conclusions: Our findings contribute to available literature in setting up the recommended standards for melanoma centers, thus improving the quality of surgery offered to patients. A consensus on the core issues around surgical morbidity is needed to provide practical guidance on morbidity prevention and management.

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Section: Surgicalmentioning

confidence: 99%

The Surgical Treatment of Non-Metastatic Melanoma in a Multicenter Registry: A Retrospective Cohort Quality Improvement Study to Reduce the Morbidity Rates

Fiore¹,

Mocellin²,

Rastrelli³

et al. 2020

Preprint

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“…Moody et al conducted a systematic review of the literature to investigate the associated postoperative morbidity associated with a CLND following SLNB compared to a TLND following regional recurrence in patients observed following a positive SLNB . Eighteen articles met inclusion criteria.…”

Section: Challenges Of Interpreting the Current Clnd Datamentioning

confidence: 99%

Completion lymphadenectomy for sentinel node positive cutaneous head & neck melanoma

Schmalbach

Bradford

2018

Laryngoscope Investig Oto

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The application and utility of melanoma sentinel lymph node biopsy (SLNB) has evolved significantly since its inception over two decades ago. The current focus has shifted from a staging modality to potentially a therapeutic intervention. Recent research to include large multi‐institutional randomized trials have attempted to answer the question: is a completion lymph node dissection (CLND) required following a positive SLNB? This review provides an evidence‐based, contemporary review of the utility of CLND for SLNB positive head and neck cutaneous melanoma patients.Level of EvidenceNA

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“…The information about SLN metastases is considered as one of the most important indicators of recurrence and survival of CM patients [1,2]. Completion lymph nodes dissection (CLND) was offered to patients with positive SLN despite signi cant morbidity which is only slightly lower in case of CLND compared to therapeutic lymphadenectomy [3]. Despite all attempts to prove otherwise, two prospective randomised studies conducted in recent years have shown that CLND does not improve survival of patients with positive SLN compared to follow up of the nodal basin with ultrasound (US) [5,6] Although there was no signi cant improvement of overall survival (OS), the MSLT-2 study did indicate, that immediate CLND offers better regional control and that non-SLN burden is an independent prognostic indicator for recurrence (hazard ratio [HR]: 1.78; p = 0.005) [5].…”

Section: Introductionmentioning

confidence: 99%

Completely Resected Stage Iii Melanoma Controversy: 15 Years Of National Tertiary Centre Experience

Perić

Milicevic

Perhavec

et al. 2020

Preprint

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BACKGROUNDTwo prospective randomized studies analysing cutaneous melanoma (CM) patients with sentinel lymph node (SLN) metastases and rapid development of adjuvant therapy have changed our approach to stage III CM treatment. The aim of this study was to compare results of retrospective survival analysis of stage III CM patients’ treatment from Slovenian national CM register to current clinical guidelines.METHODSSince 2000, all Slovenian CM patients with primary tumour ≥ TIb are treated at the Institute of Oncology Ljubljana and data are prospectively collected into a national CM registry. A retrospective analysis of 2426 sentinel lymph node (SLN) biopsies and 789 lymphadenectomies performed until 2015 was conducted using Kaplan-Meier survival curves and log-rank tests.RESULTSPositive SLN was found in 519/2426 (21.4%) of patients and completion dissection (CLND) was performed in 455 patients. The 5-year overall survival (OS) of CLND group was 58% versus 47% of metachronous metastases group (MLNM) (p = 0.003). The 5-year OS of patients with lymph node (LN) metastases and unknown primary site (UPM) was 45% versus 21% of patients with synchronous LN metastasis. Patients with SLN tumour burden < 0.3 mm had 5-year OS similar to SLN negative patients (86% vs. 85%; p = 0.926). The 5-year OS of patients with burden > 1.0 mm was similar to the MLNM group (49% vs 47%; p = 0.280). CONCLUSIONStage III melanoma patients is a heterogeneous group with significant OS differences. CLND after positive SLNB might still remain a method of treatment for some of those patients if low postoperative complication rates can be reassured.

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Complications following completion lymphadenectomy versus therapeutic lymphadenectomy for melanoma – A systematic review of the literature

Cited by 53 publications

References 35 publications

The Surgical Treatment of Non-Metastatic Melanoma in a Multicenter Registry: A Retrospective Cohort Quality Improvement Study to Reduce the Morbidity Rates

The Surgical Treatment of Non-Metastatic Melanoma in a Multicenter Registry: A Retrospective Cohort Quality Improvement Study to Reduce the Morbidity Rates

Completion lymphadenectomy for sentinel node positive cutaneous head & neck melanoma

Completely Resected Stage Iii Melanoma Controversy: 15 Years Of National Tertiary Centre Experience

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