Patients with lymphatic metastasis of cutaneous malignant melanoma benefit from sentinel lymphonodectomy and early excision of their nodal disease

Early versus delayed excision of lymph node metastases is still being assessed in malignant melanoma. In the present retrospective, multicentre study, the outcome of 314 patients with positive sentinel lymphonodectomy (SLNE) was compared with the outcome of 623 patients with delayed lymph node disse...

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Bibliographic Details
Published in:European journal of cancer (1990) 2004-01, Vol.40 (2), p.212-218
Main Authors: Kretschmer, L., Hilgers, R., Möhrle, M., Balda, B.R., Breuninger, H., Konz, B., Kunte, C., Marsch, W.C., Neumann, C., Starz, H.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Delayed excision
Dermatology
Female
Humans
Lymph Node Excision
Lymph node metastases
Lymphatic Metastasis
Male
Medical sciences
Melanoma
Melanoma - pathology
Melanoma - surgery
Pharmacology. Drug treatments
Prognosis
Prognostic factors
Retrospective Studies
Sentinel Lymph Node Biopsy - methods
Sentinel lymphonodectomy
Skin Neoplasms - pathology
Skin Neoplasms - surgery
Survival Analysis
Time Factors
Tumors
Tumors of the skin and soft tissue. Premalignant lesions
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Summary:Early versus delayed excision of lymph node metastases is still being assessed in malignant melanoma. In the present retrospective, multicentre study, the outcome of 314 patients with positive sentinel lymphonodectomy (SLNE) was compared with the outcome of 623 patients with delayed lymph node dissection (DLND) of clinically enlarged lymph node metastases. In order to avoid the lead-time bias, survival was generally calculated from the excision of the primary tumour. Survival curves were constructed using the Kaplan–Meier product-limit estimate. Cox's proportional hazards model was used to perform a multivariate analysis of factors related to overall survival. Compared with SLNE and early performed complete lymph node dissection, DLND yielded a significantly higher number of lymph node metastases. Median and mean tumour thickness were nearly identical in the two therapy groups. The estimated 3-year overall survival rate was 80.1±2.8% (±standard error of the mean (SEM)) in patients with positive SLNs, and 67.6±1.9% in patients with DLND (5-year survival rates 62.5±5.5 and 50.2±5.4%, respectively). The difference between the two survival curves was statistically significant (P=0.002). Using multifactorial analysis, SLNE (P=0.000052), American Joint Committee on Cancer (AJCC) Breslow thickness category (P
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2003.07.003