1. Deep lymph node metastases in the groin significantly affects prognosis, particularly in sentinel node-positive melanoma patients.
- Author
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Niebling MG, Wevers KP, Suurmeijer AJ, van Ginkel RJ, and Hoekstra HJ
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Groin surgery, Humans, Lymph Node Excision, Lymph Nodes surgery, Lymphatic Metastasis, Male, Melanoma mortality, Melanoma surgery, Middle Aged, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local surgery, Neoplasm Staging, Neoplasms, Second Primary mortality, Neoplasms, Second Primary surgery, Prognosis, Skin Neoplasms mortality, Skin Neoplasms surgery, Survival Rate, Young Adult, Groin pathology, Lymph Nodes pathology, Melanoma pathology, Neoplasm Recurrence, Local pathology, Neoplasms, Second Primary pathology, Sentinel Lymph Node Biopsy, Skin Neoplasms secondary
- Abstract
Background: In order to define patients eligible for only a superficial groin dissection or a combined superficial and deep groin dissection, this study aimed to determine the incidence of deep lymph node metastases (LNM) in patients with melanoma metastasized to the groin, to identify patient and melanoma factors that predict deep nodal involvement, and to analyze the impact of deep nodal involvement on survival and recurrence., Methods: Patients who underwent a combined superficial (inguinal) and deep (iliac and obturator) complete (CLND) or therapeutic lymph node dissection (TLND) of the groin between 1994 and 2012 were analyzed., Results: QueryDeep LNM were found in 8 of 62 CLND patients (13 %) and in 21 of 67 TLND patients (31 %). More than three superficial LNM was the only independent predictor for deep LNM in both CLND and TLND patients. The 5-year melanoma-specific survival (MSS) for CLND and TLND patients with deep LNM was 14.3 and 16.6 %, respectively, and was significantly worse (hazard ratio [HR] 3.39, 95 % CI 1.34-8.58, p = 0.010; and HR 2.01, 95 % CI 1.04-3.88, p = 0.039) compared with CLND and TLND patients without deep LNM (5-year MSS: 54.1 and 37.2 %, respectively). Distant recurrence was significantly associated with deep LNM in CLND patients (p = 0.032)., Conclusions: The present study showed that LNM in the deep area of the groin are fairly common in both CLND and TLND patients and significantly affect prognosis, especially in CLND patients. The number of superficial LNM is the only factor that was found to predict a finding of deep nodal metastases.
- Published
- 2015
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