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Is there a therapeutic benefit of complete lymph node dissection in melanoma patients with low tumor burden in the sentinel node?

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Is there a therapeutic benefit of complete lymph node dissection in melanoma patients with low tumor burden in the sentinel node? / Meier, Andre; Zapf, Antonia; Niebuhr, Margarete; Kapp, Alexander; Gutzmer, Ralf.

In: MELANOMA RES, Vol. 24, No. 5, 10.2014, p. 454-461.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Meier, A, Zapf, A, Niebuhr, M, Kapp, A & Gutzmer, R 2014, 'Is there a therapeutic benefit of complete lymph node dissection in melanoma patients with low tumor burden in the sentinel node?', MELANOMA RES, vol. 24, no. 5, pp. 454-461. https://doi.org/10.1097/CMR.0000000000000081

APA

Meier, A., Zapf, A., Niebuhr, M., Kapp, A., & Gutzmer, R. (2014). Is there a therapeutic benefit of complete lymph node dissection in melanoma patients with low tumor burden in the sentinel node? MELANOMA RES, 24(5), 454-461. https://doi.org/10.1097/CMR.0000000000000081

Vancouver

Meier A, Zapf A, Niebuhr M, Kapp A, Gutzmer R. Is there a therapeutic benefit of complete lymph node dissection in melanoma patients with low tumor burden in the sentinel node? MELANOMA RES. 2014 Oct;24(5):454-461. https://doi.org/10.1097/CMR.0000000000000081

Bibtex

@article{a2178b05bc2b4d2285f6e7081d5d7a68,
title = "Is there a therapeutic benefit of complete lymph node dissection in melanoma patients with low tumor burden in the sentinel node?",
abstract = "In the case of a positive sentinel lymph node (SLN), melanoma patients are recommended to proceed to complete lymph node dissection (CLND). However, CLND for SLN-positive patients - especially with minimal tumor burden in SLN - is becoming more controversial. We analyzed the clinical course of 305 SLN-positive patients with a mean follow-up of 51.1 months by Kaplan-Meier analyses. Overall, 58/305 (17%) patients did not undergo CLND. These were compared with a matched selection of 58 comparable patients who underwent CLND. Moreover, 106/305 patients with minimal tumor burden in SLN (<0.1 mm diameter of the largest tumor deposit) were analyzed separately. Of these 106 patients, 34 did not undergo CLND, whereas 72/106 patients were treated by CLND. In the matched groups, the CLND group and the non-CLND group did not differ significantly with respect to clinical characteristics, characteristics of the primary melanoma, and histopathological parameters of SLN. There were no differences in recurrence-free survival (P=0.765) and overall survival (P=0.844). The total number of regional lymph node metastases and time to regional lymph node metastases were not significantly higher for non-CLND patients. The subgroup of patients with minimal tumor burden in SLN also did not benefit significantly from CLND. In our analyses from a single German center, we could not find any evidence for a therapeutic survival benefit for CLND after positive SLN. However, future prospective randomized trials should confirm these data.",
keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Child, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Lymph Node Excision, Lymphatic Metastasis, Male, Melanoma, Middle Aged, Multivariate Analysis, Prognosis, Proportional Hazards Models, Recurrence, Sentinel Lymph Node Biopsy, Treatment Outcome, Tumor Burden, Young Adult, Journal Article",
author = "Andre Meier and Antonia Zapf and Margarete Niebuhr and Alexander Kapp and Ralf Gutzmer",
year = "2014",
month = oct,
doi = "10.1097/CMR.0000000000000081",
language = "English",
volume = "24",
pages = "454--461",
journal = "MELANOMA RES",
issn = "0960-8931",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

RIS

TY - JOUR

T1 - Is there a therapeutic benefit of complete lymph node dissection in melanoma patients with low tumor burden in the sentinel node?

AU - Meier, Andre

AU - Zapf, Antonia

AU - Niebuhr, Margarete

AU - Kapp, Alexander

AU - Gutzmer, Ralf

PY - 2014/10

Y1 - 2014/10

N2 - In the case of a positive sentinel lymph node (SLN), melanoma patients are recommended to proceed to complete lymph node dissection (CLND). However, CLND for SLN-positive patients - especially with minimal tumor burden in SLN - is becoming more controversial. We analyzed the clinical course of 305 SLN-positive patients with a mean follow-up of 51.1 months by Kaplan-Meier analyses. Overall, 58/305 (17%) patients did not undergo CLND. These were compared with a matched selection of 58 comparable patients who underwent CLND. Moreover, 106/305 patients with minimal tumor burden in SLN (<0.1 mm diameter of the largest tumor deposit) were analyzed separately. Of these 106 patients, 34 did not undergo CLND, whereas 72/106 patients were treated by CLND. In the matched groups, the CLND group and the non-CLND group did not differ significantly with respect to clinical characteristics, characteristics of the primary melanoma, and histopathological parameters of SLN. There were no differences in recurrence-free survival (P=0.765) and overall survival (P=0.844). The total number of regional lymph node metastases and time to regional lymph node metastases were not significantly higher for non-CLND patients. The subgroup of patients with minimal tumor burden in SLN also did not benefit significantly from CLND. In our analyses from a single German center, we could not find any evidence for a therapeutic survival benefit for CLND after positive SLN. However, future prospective randomized trials should confirm these data.

AB - In the case of a positive sentinel lymph node (SLN), melanoma patients are recommended to proceed to complete lymph node dissection (CLND). However, CLND for SLN-positive patients - especially with minimal tumor burden in SLN - is becoming more controversial. We analyzed the clinical course of 305 SLN-positive patients with a mean follow-up of 51.1 months by Kaplan-Meier analyses. Overall, 58/305 (17%) patients did not undergo CLND. These were compared with a matched selection of 58 comparable patients who underwent CLND. Moreover, 106/305 patients with minimal tumor burden in SLN (<0.1 mm diameter of the largest tumor deposit) were analyzed separately. Of these 106 patients, 34 did not undergo CLND, whereas 72/106 patients were treated by CLND. In the matched groups, the CLND group and the non-CLND group did not differ significantly with respect to clinical characteristics, characteristics of the primary melanoma, and histopathological parameters of SLN. There were no differences in recurrence-free survival (P=0.765) and overall survival (P=0.844). The total number of regional lymph node metastases and time to regional lymph node metastases were not significantly higher for non-CLND patients. The subgroup of patients with minimal tumor burden in SLN also did not benefit significantly from CLND. In our analyses from a single German center, we could not find any evidence for a therapeutic survival benefit for CLND after positive SLN. However, future prospective randomized trials should confirm these data.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Child

KW - Disease-Free Survival

KW - Female

KW - Humans

KW - Kaplan-Meier Estimate

KW - Lymph Node Excision

KW - Lymphatic Metastasis

KW - Male

KW - Melanoma

KW - Middle Aged

KW - Multivariate Analysis

KW - Prognosis

KW - Proportional Hazards Models

KW - Recurrence

KW - Sentinel Lymph Node Biopsy

KW - Treatment Outcome

KW - Tumor Burden

KW - Young Adult

KW - Journal Article

U2 - 10.1097/CMR.0000000000000081

DO - 10.1097/CMR.0000000000000081

M3 - SCORING: Journal article

C2 - 24811213

VL - 24

SP - 454

EP - 461

JO - MELANOMA RES

JF - MELANOMA RES

SN - 0960-8931

IS - 5

ER -