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Quantification of Tumor Cell Adhesion in Lymph Node Cryosections
Published on: February 9, 2020
Risk factors for nodal recurrence after lymphadenectomy for melanoma
I Pidhorecky1, R J Lee, G Proulx
1Division of Surgical Oncology, Roswell Park Cancer Institute, State University of New York, Buffalo 14263, USA.
Annals of Surgical Oncology
|March 22, 2001
Summary
Elective lymph node dissection (ELND) showed lower regional recurrence and better survival than therapeutic lymph node dissection (TLND) for melanoma patients. Tumor burden and location impact relapse risk, but salvage is possible with repeat dissection.
Area of Science:
- Melanoma research
- Surgical oncology
- Clinical outcomes
Background:
- Evaluating regional failure risk and outcomes after lymph node dissection for melanoma.
- Assessing outcomes without adjuvant radiotherapy for microscopically and macroscopically involved lymph nodes.
Purpose of the Study:
- To compare the risk and outcome of regional failure between elective lymph node dissection (ELND) and therapeutic lymph node dissection (TLND).
- To identify risk factors for nodal recurrence and their impact on survival.
Main Methods:
- Retrospective review of 338 melanoma patients (1970-1996) with pathologically involved lymph nodes.
- Analysis of outcomes for ELND (n=85) versus TLND (n=253) groups.
Main Results:
- Regional recurrence was lower with ELND (14%) than TLND (28%).
- Risk factors for recurrence included advanced age, head/neck primary, lesion depth, nodal involvement, and extracapsular extension (ECE).
- 10-year disease-specific survival was significantly higher for ELND (51%) vs. TLND (30%). Nodal basin failure predicted distant metastasis.
Conclusions:
- Patients with high tumor burden, advanced age, or head/neck primary melanoma face increased relapse risk and decreased survival after ELND or TLND.
- Isolated nodal recurrence is uncommon but often salvageable with a second dissection.
