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

D. Verver, M. F. Madu, C. M. C. Oude Ophuis, M. Faut, J. H. W. de Wilt, J. J. Bonenkamp, D. J. Grünhagen, A. C. J. van Akkooi, C. Verhoef, B. L. van Leeuwen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The optimal extent of groin completion lymph node dissection (CLND) (inguinal or ilioinguinal dissection) in patients with melanoma is controversial. The aim of this study was to evaluate whether the extent of groin CLND after a positive sentinel node biopsy (SNB) is associated with improved outcome. Methods: Data from all sentinel node-positive patients who underwent groin CLND at four tertiary melanoma referral centres were retrieved retrospectively. Baseline patient and tumour characteristics were collected for descriptive statistics, survival analyses and Cox proportional hazards regression analyses. Results: In total, 255 patients were included, of whom 137 (53·7 per cent) underwent inguinal dissection and 118 (46·3 per cent) ilioinguinal dissection. The overall CLND positivity rate was 18·8 per cent; the inguinal positivity rate was 15·5 per cent and the pelvic positivity rate was 9·3 per cent. The pattern of recurrence, and 5-year melanoma-specific survival, disease-free survival and distant-metastasis free survival rates were similar for both dissection types, even for patients with a positive CLND result. Cox regression analysis showed that type of CLND was not associated with disease-free or melanoma-specific survival. Conclusion: There was no significant difference in recurrence pattern and survival rates between patients undergoing inguinal or ilioinguinal dissection after a positive SNB, even after stratification for a positive CLND result. An inguinal dissection is a safe first approach as CLND in patients with a positive SNB.
Original languageEnglish
Pages (from-to)96-105
JournalBritish Journal of Surgery
Volume105
Issue number1
DOIs
Publication statusPublished - 2018
Externally publishedYes

Cite this

Verver, D. ; Madu, M. F. ; Oude Ophuis, C. M. C. ; Faut, M. ; de Wilt, J. H. W. ; Bonenkamp, J. J. ; Grünhagen, D. J. ; van Akkooi, A. C. J. ; Verhoef, C. ; van Leeuwen, B. L. / Optimal extent of completion lymphadenectomy for patients with melanoma and a positive sentinel node in the groin. In: British Journal of Surgery. 2018 ; Vol. 105, No. 1. pp. 96-105.
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title = "Optimal extent of completion lymphadenectomy for patients with melanoma and a positive sentinel node in the groin",
abstract = "Background: The optimal extent of groin completion lymph node dissection (CLND) (inguinal or ilioinguinal dissection) in patients with melanoma is controversial. The aim of this study was to evaluate whether the extent of groin CLND after a positive sentinel node biopsy (SNB) is associated with improved outcome. Methods: Data from all sentinel node-positive patients who underwent groin CLND at four tertiary melanoma referral centres were retrieved retrospectively. Baseline patient and tumour characteristics were collected for descriptive statistics, survival analyses and Cox proportional hazards regression analyses. Results: In total, 255 patients were included, of whom 137 (53·7 per cent) underwent inguinal dissection and 118 (46·3 per cent) ilioinguinal dissection. The overall CLND positivity rate was 18·8 per cent; the inguinal positivity rate was 15·5 per cent and the pelvic positivity rate was 9·3 per cent. The pattern of recurrence, and 5-year melanoma-specific survival, disease-free survival and distant-metastasis free survival rates were similar for both dissection types, even for patients with a positive CLND result. Cox regression analysis showed that type of CLND was not associated with disease-free or melanoma-specific survival. Conclusion: There was no significant difference in recurrence pattern and survival rates between patients undergoing inguinal or ilioinguinal dissection after a positive SNB, even after stratification for a positive CLND result. An inguinal dissection is a safe first approach as CLND in patients with a positive SNB.",
author = "D. Verver and Madu, {M. F.} and {Oude Ophuis}, {C. M. C.} and M. Faut and {de Wilt}, {J. H. W.} and Bonenkamp, {J. J.} and Gr{\"u}nhagen, {D. J.} and {van Akkooi}, {A. C. J.} and C. Verhoef and {van Leeuwen}, {B. L.}",
year = "2018",
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Verver, D, Madu, MF, Oude Ophuis, CMC, Faut, M, de Wilt, JHW, Bonenkamp, JJ, Grünhagen, DJ, van Akkooi, ACJ, Verhoef, C & van Leeuwen, BL 2018, 'Optimal extent of completion lymphadenectomy for patients with melanoma and a positive sentinel node in the groin' British Journal of Surgery, vol. 105, no. 1, pp. 96-105. https://doi.org/10.1002/bjs.10644

Optimal extent of completion lymphadenectomy for patients with melanoma and a positive sentinel node in the groin. / Verver, D.; Madu, M. F.; Oude Ophuis, C. M. C.; Faut, M.; de Wilt, J. H. W.; Bonenkamp, J. J.; Grünhagen, D. J.; van Akkooi, A. C. J.; Verhoef, C.; van Leeuwen, B. L.

In: British Journal of Surgery, Vol. 105, No. 1, 2018, p. 96-105.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Optimal extent of completion lymphadenectomy for patients with melanoma and a positive sentinel node in the groin

AU - Verver, D.

AU - Madu, M. F.

AU - Oude Ophuis, C. M. C.

AU - Faut, M.

AU - de Wilt, J. H. W.

AU - Bonenkamp, J. J.

AU - Grünhagen, D. J.

AU - van Akkooi, A. C. J.

AU - Verhoef, C.

AU - van Leeuwen, B. L.

PY - 2018

Y1 - 2018

N2 - Background: The optimal extent of groin completion lymph node dissection (CLND) (inguinal or ilioinguinal dissection) in patients with melanoma is controversial. The aim of this study was to evaluate whether the extent of groin CLND after a positive sentinel node biopsy (SNB) is associated with improved outcome. Methods: Data from all sentinel node-positive patients who underwent groin CLND at four tertiary melanoma referral centres were retrieved retrospectively. Baseline patient and tumour characteristics were collected for descriptive statistics, survival analyses and Cox proportional hazards regression analyses. Results: In total, 255 patients were included, of whom 137 (53·7 per cent) underwent inguinal dissection and 118 (46·3 per cent) ilioinguinal dissection. The overall CLND positivity rate was 18·8 per cent; the inguinal positivity rate was 15·5 per cent and the pelvic positivity rate was 9·3 per cent. The pattern of recurrence, and 5-year melanoma-specific survival, disease-free survival and distant-metastasis free survival rates were similar for both dissection types, even for patients with a positive CLND result. Cox regression analysis showed that type of CLND was not associated with disease-free or melanoma-specific survival. Conclusion: There was no significant difference in recurrence pattern and survival rates between patients undergoing inguinal or ilioinguinal dissection after a positive SNB, even after stratification for a positive CLND result. An inguinal dissection is a safe first approach as CLND in patients with a positive SNB.

AB - Background: The optimal extent of groin completion lymph node dissection (CLND) (inguinal or ilioinguinal dissection) in patients with melanoma is controversial. The aim of this study was to evaluate whether the extent of groin CLND after a positive sentinel node biopsy (SNB) is associated with improved outcome. Methods: Data from all sentinel node-positive patients who underwent groin CLND at four tertiary melanoma referral centres were retrieved retrospectively. Baseline patient and tumour characteristics were collected for descriptive statistics, survival analyses and Cox proportional hazards regression analyses. Results: In total, 255 patients were included, of whom 137 (53·7 per cent) underwent inguinal dissection and 118 (46·3 per cent) ilioinguinal dissection. The overall CLND positivity rate was 18·8 per cent; the inguinal positivity rate was 15·5 per cent and the pelvic positivity rate was 9·3 per cent. The pattern of recurrence, and 5-year melanoma-specific survival, disease-free survival and distant-metastasis free survival rates were similar for both dissection types, even for patients with a positive CLND result. Cox regression analysis showed that type of CLND was not associated with disease-free or melanoma-specific survival. Conclusion: There was no significant difference in recurrence pattern and survival rates between patients undergoing inguinal or ilioinguinal dissection after a positive SNB, even after stratification for a positive CLND result. An inguinal dissection is a safe first approach as CLND in patients with a positive SNB.

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