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Regional control after precision lymph node dissection for clinically evident melanoma metastasis.

Publication ,  Journal Article
Lynch, KT; Hu, Y; Farrow, NE; Song, Y; Meneveau, MO; Kwak, M; Lowe, MC; Bartlett, EK; Beasley, GM; Karakousis, GC; Slingluff, CL
Published in: J Surg Oncol
January 2023

INTRODUCTION: Completion lymph node dissection (CLND) for microscopic lymph node metastases has been replaced by observation; however, CLND is standard for clinically detectable nodal metastases (cLN). CLND has high morbidity, which may be reduced by excision of only the cLN (precision lymph node dissection [PLND]). We hypothesized that same-basin recurrence risk would be low after PLND. METHODS: Retrospective review at four tertiary care hospitals identified patients who underwent PLND. The primary outcome was 3-year cumulative incidence of isolated same-basin recurrence. RESULTS: Twenty-one patients underwent PLND for cLN without synchronous distant metastases. Reasons for forgoing CLND included patient preference (n = 11), comorbidities (n = 5), imaging indeterminate for distant metastases (n = 2), partial response to checkpoint blockade (n = 1), or not reported (n = 2). A median of 2 nodes (range: 1-6) were resected at PLND, and 68% contained melanoma. Recurrence was observed in 33% overall. Only 1 patient (5%) developed an isolated same-basin recurrence. Cumulative incidences at 3 years were 5.0%, 17.3%, and 49.7% for isolated same-basin recurrence, any same-basin recurrence, and any recurrence, respectively. Complications from PLND were reported in 1 patient (5%). CONCLUSIONS: These pilot data suggest that PLND may provide adequate regional disease control with less morbidity than CLND. These data justify prospective evaluation of PLND in select patients.

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Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

January 2023

Volume

127

Issue

1

Start / End Page

140 / 147

Location

United States

Related Subject Headings

  • Syndrome
  • Skin Neoplasms
  • Sentinel Lymph Node Biopsy
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Melanoma
  • Lymphatic Metastasis
  • Lymph Nodes
  • Lymph Node Excision
  • Humans
 

Citation

APA
Chicago
ICMJE
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Lynch, K. T., Hu, Y., Farrow, N. E., Song, Y., Meneveau, M. O., Kwak, M., … Slingluff, C. L. (2023). Regional control after precision lymph node dissection for clinically evident melanoma metastasis. J Surg Oncol, 127(1), 140–147. https://doi.org/10.1002/jso.27100
Lynch, Kevin T., Yinin Hu, Norma E. Farrow, Yun Song, Max O. Meneveau, Minyoung Kwak, Michael C. Lowe, et al. “Regional control after precision lymph node dissection for clinically evident melanoma metastasis.J Surg Oncol 127, no. 1 (January 2023): 140–47. https://doi.org/10.1002/jso.27100.
Lynch KT, Hu Y, Farrow NE, Song Y, Meneveau MO, Kwak M, et al. Regional control after precision lymph node dissection for clinically evident melanoma metastasis. J Surg Oncol. 2023 Jan;127(1):140–7.
Lynch, Kevin T., et al. “Regional control after precision lymph node dissection for clinically evident melanoma metastasis.J Surg Oncol, vol. 127, no. 1, Jan. 2023, pp. 140–47. Pubmed, doi:10.1002/jso.27100.
Lynch KT, Hu Y, Farrow NE, Song Y, Meneveau MO, Kwak M, Lowe MC, Bartlett EK, Beasley GM, Karakousis GC, Slingluff CL. Regional control after precision lymph node dissection for clinically evident melanoma metastasis. J Surg Oncol. 2023 Jan;127(1):140–147.
Journal cover image

Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

January 2023

Volume

127

Issue

1

Start / End Page

140 / 147

Location

United States

Related Subject Headings

  • Syndrome
  • Skin Neoplasms
  • Sentinel Lymph Node Biopsy
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Melanoma
  • Lymphatic Metastasis
  • Lymph Nodes
  • Lymph Node Excision
  • Humans