Is superficial inguinal node dissection adequate for regional control of malignant melanoma in patients with N1 disease?

Optimal extent of completion lymphadenectomy for patients with melanoma and a positive sentinel node in the groin

“…Some authors advocate ilioinguinal dissection to optimize regional control and possibly increase survival. Others disagree and advocate an inguinal dissection, especially in patients with low suspicion of pelvic nodal metastasis, because ilioinguinal dissection is believed to be associated with increased morbidity and does not seem to affect outcome.…”

“…The majority of studies comparing these two types of dissection have been limited to those with palpable disease, or did not differentiate between patients with a positive SNB or palpable disease. It has been demonstrated, however, that patients with a positive SNB differ from those with palpable disease in tumour biology, rate of pelvic nodal involvement, recurrence pattern and survival rate.…”

Effectiveness of intraoperative indocyanine-green fluorescence angiography during inguinal lymph node dissection for skin cancer to prevent postoperative wound dehiscence

“…DgD was performed using a lazy S incision. The excised tissue from the DgD was the same as that defined by Smith et al, including all lymph nodes, including cloquet's node, found within a triangular area bounded by the inguinal ligament superiorly, the medial border of the adductor longus medially and the medial border of the sartorius laterally [11]. This tissue includes that reaching deep to the fascia lata within the femoral sheath.…”

“…The excised tissue included the same tissue as DgD, as well as the external iliac and obturator nodes within the pelvis, to which the inguinal nodes drain, and this procedure requires skeletonization of the external iliac vessels [11]. The approach into the iliac and obturator nodes within the pelvis was performed through the same lazy S skin incision as DgD, with the incision extended to the umbilical height on the lower abdomen.…”

The nomenclature of groin dissection for melanoma – Time to simplify

“…Clearly, standardisation is necessary.Previous studies evaluating groin dissection in melanoma have highlighted the limitations of comparative research given that the confusing array of published terminology makes identifying specific patient populations extremely difficult(3,4). Additionally, studies evaluating unstandardised nomenclature in parotid and oculoplastic surgery have suggested that it limits the effectiveness of in groin disease management in melanoma given the controversies that still exist with regards to optimum extent of dissection and advocation by some authors of more conservative management in patients with low tumour burden(3,7).The ongoing EA-GLEeFM and MSLT-II trials highlight the need for more standardised nomenclature. EA-GLEeFM aims to evaluate the effect of "inguinal" vs "ilioinguinal" dissection on disease free survival in patients without pelvic disease(8).…”