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Lymph node dissection for clinically evident lymph node metastases of malignant melanoma
Thomas Meyer1, Susanne Merkel, Jonas Göhl
1Department of Surgery, University of Erlangen, Erlangen, Germany. thomas.meyer@chir.imed.uni-erlangen.de
Summary
Therapeutic lymph node dissection (TLND) offers a chance of cure for about one-third of melanoma patients with regional lymph node metastases. Prognosis is poorer for older patients, those with trunk tumors, multiple metastases, or extracapsular spread.
Area of Science:
- Oncology
- Surgical Oncology
- Melanoma Research
Background:
- Regional lymph node metastases are common in melanoma patients.
- Prognostic factors after therapeutic lymph node dissection (TLND) require evaluation.
Purpose of the Study:
- To identify factors influencing patient prognosis after TLND for melanoma.
- To assess the overall survival and identify independent prognostic indicators.
Main Methods:
- Retrospective review of 140 melanoma patients who underwent TLND between 1978 and 1997.
- Univariate and multivariate survival analyses were performed to identify prognostic factors.
Main Results:
- Median survival was 25 months, with a 5-year survival rate of 30%.
- Independent poor prognostic factors identified: age >50 years, trunk primary tumor site, >3 positive lymph nodes, and extracapsular spread.
- Multivariate analysis confirmed age, tumor location, lymph node count, and extracapsular spread as significant independent prognostic factors (P=0.02 to P=0.04).
Conclusions:
- TLND is a valuable treatment for melanoma with regional lymph node metastases, offering a potential cure for approximately one-third of patients.
- Specific patient subgroups, identified by prognostic factors, have a limited benefit from surgery alone, suggesting a need for tailored treatment strategies.