Ilioinguinal Lymph Node Dissection for Palpable Metastatic Melanoma to the Groin

Allan, Christopher Paul; Hayes, Andrew; Thomas, Joseph

doi:10.1111/j.1445-2197.2008.04716.x

Cited by 44 publications

(42 citation statements)

References 25 publications

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“…The overall rate of recurrence in the same basin was 4%, which compares favorably to rates reported for DGD +/− IOD. 6,12,13,20 (Table 4) Like other published studies, we found that number of positive nodes and extracapsular extension are better predictors of poor outcome than palpable tumor burden in the groin. 20–22 Thus, even in patients with palpable disease, SGD is appropriate for clearance of lymph nodes from the groin.…”

Section: Discussionsupporting

confidence: 82%

“…Published rates of seroma, infection, wound breakdown, and lymphedema were collected for comparison. 4, 7, 12, 14–16, 19 (Table 3)…”

Section: Resultsmentioning

confidence: 99%

“…We present our regional control rates in the context of reported experience where appropriate. 6,7,12–17 We hypothesized that regional control would be better for patients with micrometastases (found on SLN biopsy) than for macroscopic metastases (found on clinical exam as palpable lymphadenopathy). We believed that SGD would have a morbidity equivalent to or better than that seen for DGD with or without IOD.…”

Section: Introductionmentioning

confidence: 99%

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Regional Control and Morbidity After Superficial Groin Dissection in Melanoma

Shada

Slingluff

2010

Ann Surg Oncol

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Background There is no consensus about the optimal extent of surgery for patients with melanoma metastases to inguinal nodes, and this is further complicated by variations in terminology for these dissections. In patients without clinical evidence of iliac metastases, we routinely perform a superficial groin dissection (SGD), which clears node-bearing tissue superficial to the fascia lata. We hypothesized that SGD provides regional tumor control comparable to published experience with deep groin dissection (DGD) and iliac and obturator dissection (IOD), but with less morbidity. Methods A retrospective review of a prospectively collected database evaluated patients undergoing SGD April 1994 through May 2008. Patients with clinical evidence of iliac metastases were excluded. Clinical and pathologic data regarding recurrence and survival were evaluated. Results We identified 53 primary SGD: 27 for clinically palpable disease, and 25 for microscopic disease. Number and percentage of positive nodes were similar between groups. Median followup was 39 months, and two patients had primary recurrence in the groin (one in each group). Two additional patients had concurrent groin and systemic recurrence. Five-year Kaplan-Meier estimates for ipsilateral groin recurrence prior to systemic disease, were similar at 9.7% (SE 6.5) and 7.7% (SE 7.4), for microscopic and palpable disease respectively. Similarly, survival was comparable between groups (73% and 82%). Toxicities were comparable to previously published data. Conclusion SGD provides regional control rates similar to DGD and IOD, for lymph node metastases clinically limited to the groin, whether occult or clinically evident.

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Section: Discussionsupporting

confidence: 82%

“…Published rates of seroma, infection, wound breakdown, and lymphedema were collected for comparison. 4, 7, 12, 14–16, 19 (Table 3)…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Regional Control and Morbidity After Superficial Groin Dissection in Melanoma

Shada

Slingluff

2010

Ann Surg Oncol

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“…Letztere bezieht die intrapelvinen iliakalen und Obturator-LK mit ein. Patienten mit tastbaren Metastasen in der Leiste haben in 27 -52 % der Fälle auch einen Befall der Lymphknoten des kleinen Beckens (Literaturübersicht in [3]). Daher vertreten viele Autoren die Auffassung, dass bei klinisch vergrößerten LKM grundsätzlich die radikalere ilioinguinale Lymphknotendissektion durchgeführt werden sollte.…”

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“…Eine iliakale Dissektion müsste demnach nur dann durchgeführt werden, wenn LK-Vergrößerungen im Bereich des kleinen Beckens mithilfe einer bildgebenden Methode, z. B. der Computertomografie diagnostiziert werden [3,5]. Fälle von Langzeitüberleben nach pelviner Metastasierung wurden vorwiegend für Patienten mit ausschließlich mikroskopischer (klinisch okkulter) Metastasierung oder für Patienten mit "Skip-Metastasen" im kleinen Becken (iliakale LKM ohne vorgeschaltete inguinale LKM) beschrieben [6,7].…”

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