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

Area of Science:

• Oncology
• Surgical Oncology
• Melanoma Research

Background:

• Completion lymph node dissection (CLND) is standard for clinically detected nodal metastases (cLN) but has high morbidity.
• Precision lymph node dissection (PLND), excising only clinically detected nodes, may reduce morbidity.
• This study investigates the recurrence risk after PLND.

Purpose of the Study:

• To evaluate the 3-year cumulative incidence of isolated same-basin recurrence after precision lymph node dissection (PLND).
• To assess the safety and efficacy of PLND as an alternative to CLND for clinically detected nodal metastases in melanoma.

Main Methods:

• Retrospective review of patients who underwent PLND across four tertiary care hospitals.
• Analysis of 3-year cumulative incidence of isolated same-basin recurrence as the primary outcome.
• Data collected on patient demographics, reasons for choosing PLND, nodes resected, and recurrence events.

Main Results:

• Twenty-one patients underwent PLND for clinically detected nodal metastases without distant disease.
• A median of 2 nodes were resected, with 68% containing melanoma.
• Only 1 patient (5%) experienced isolated same-basin recurrence; 33% had any recurrence.
• Complications were reported in only 5% of patients.

Conclusions:

• Pilot data suggest PLND offers adequate regional disease control with reduced morbidity compared to CLND.
• PLND may be a viable option for select melanoma patients with clinically detected nodal metastases.
• Prospective evaluation of PLND is warranted to confirm these findings.