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[Axillary recurrence after lymph node excision in malignant melanoma]
L Kretschmer1, C Lautenschläger, K P Preusser
1Hautklinik, Martin-Luther-Universität Halle-Wittenberg.
Langenbecks Archiv Fur Chirurgie
|January 1, 1993
Summary
Axillary lymphadenectomy recurrence is common in stage II, with regional metastases being a key predictor. Early detection and management are crucial for improving survival rates in advanced cancer stages.
Area of Science:
- Oncology
- Surgical Pathology
- Clinical Research
Context:
- Retrospective analysis of 143 patients undergoing 155 axillary lymphadenectomies.
- Patients categorized into Stage I (negative nodes), Stage II (node metastases), and Stage III (node and distant metastases).
- Maximum follow-up of 8 years (mean 51.9 months).
Purpose:
- To evaluate the incidence and prognostic factors of axillary recurrence after lymphadenectomy.
- To assess the impact of recurrence on patient survival.
- To identify predictors for recurrence in different stages of axillary lymph node involvement.
Summary:
- Five-year survival rates were 77.5% for Stage I and 28.6% for Stage II.
- Axillary recurrence occurred in 30.7% of Stage II patients, exclusively within 20 months post-surgery.
- Regional in-transit cutaneous metastases were the sole significant predictor (p=0.048) of recurrence in Stage II; other factors like tumor characteristics and adjuvant chemotherapy did not show significance.
Impact:
- Regional in-transit cutaneous metastases are a critical indicator for axillary recurrence risk in Stage II disease.
- Median survival post-recurrence (5 months) is poor and comparable to Stage III lymphadenectomy survival (7 months).
- High incidence (>30%) of regional metastases observed in both recurrent and Stage III groups, highlighting treatment challenges.