scholarly journals Postoperative Complications following Nodal Dissection and Their Association with Melanoma Recurrence

ISRN Surgery ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Abubakr Ahmed ◽  
Gaitri Sadadcharam ◽  
Felicity Huisma ◽  
Katrina Fogarty ◽  
Muhammad Mushtaque ◽  
...  
Keyword(s):  
Lymph Node ◽  
Malignant Melanoma ◽  
Postoperative Complications ◽  
Disease Recurrence ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Significant Difference ◽  
Nodal Dissection ◽  
Melanoma Patients ◽  
Inguinal Dissection

Background. Although postoperative complications are common after lymph node dissection, its association with disease recurrence has not yet been fully investigated. Methods. A retrospective review of a prospectively maintained database was conducted, looking at all malignant melanoma patients with sentinel nodes positive disease requiring axillary or inguinal dissection between 2002 and 2011. Results. A total of 124 patients required nodal clearance from 317 patients with stage I/II malignant melanoma who had undergone sentinel lymph node biopsy. Of these, 104 patients met the inclusion criteria and were divided into inguinal lymph node dissections (ILND; ) or axillary lymph node dissections (ALND; ). Immunohistochemical deposits had higher detection rate in ALND (). The ILND patients had a higher recurrence rate (84.1% versus 63.4%; ) and mortality (68.3% versus 48.8%; ) without a significant difference in complications. In patients whom complications developed, 75% of the ILND group and 71.4% of the ALND group had disease recurrence, but without reaching a statistical value as an independent predictor of melanoma recurrence. Conclusion. Complications are common following ILND and ALND; however there is no significant difference in complications rates between the groups with some associations with recurrence without reaching a significant difference.

scholarly journals Predictive Factors for the Positivity of the Sentinel Lymph Node in Malignant Melanoma

2017 ◽  
Vol 2 (4) ◽  
pp. 332-337
Author(s):  
Călin Crăciun ◽  
Orsolya Hankó-Bauer ◽  
Zalán Benedek ◽  
Sorin Sorlea ◽  
Marius Florin Coroș ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Malignant Melanoma ◽  
Lymph Nodes ◽  
Predictive Factors ◽  
Standard Procedure ◽  
Lymph Node Biopsy ◽  
Pigment Cells ◽  
Number Of Patients ◽  
Melanoma Patients

AbstractMalignant melanoma is a neoplasia that has its origin in the melanocytes, the melanin-synthesizing pigment cells present in the epidermis or sometimes in the dermis. Sentinel lymph node biopsy (SLNB) is the standard procedure used for staging patients with malignant melanoma in the majority of surgical centers in the world. With a probability of approximately 20% of finding positive lymph nodes, it spares a large number of patients of a complete lymphatic dissection. The aim of this study is to evaluate the factors that can predict the positivity of sentinel lymph nodes in malignant melanoma patients. We performed a retrospective study analyzing the histopathologic reports of patients who underwent SLNB for malignant melanoma between 2012 and 2015. There were 32 patients identified, out of which only three (9.37%) had positive SLN, so the majority of our patients were spared of regional lymphatic dissection. In our series, lymphatic invasion (p = 0.01), Breslow index >4 mm (p = 0.0064), AJCC staging (p = 0.0008), the presence of precursory lesions (p = 002), and microsatellitosis (p = 0.017) were predictive factors for the positivity of the SLN in malignant melanoma patients. Although our results are similar to those published in the literature, we consider that larger cohort studies should be performed to consolidate our results.

scholarly journals Comparative Analysis of Main Clinical Features and Survival in Patients with Cutaneous Malignant Melanoma with and without Sentinel Lymph Node Biopsy

2020 ◽  
Author(s):  
Strashilov Strahil ◽  
Joana Ivanova Simeonova ◽  
Assia Andrianova Konsoulova ◽  
Mariela Borisova Vasileva-Slaveva ◽  
Angel Dancev Yordanov
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Malignant Melanoma ◽  
Lymph Node Biopsy ◽  
Cutaneous Malignant Melanoma ◽  
University Hospital ◽  
Node Biopsy ◽  
Significant Difference ◽  
Group A

Abstract Background Sentinel lymph node biopsy is fundamental in the treatment and prognosis of cutaneous malignant melanoma. The aim of this study is to identify differences in baseline clinical characteristics and survival of patients with melanoma with and without sentinel lymph node biopsy (SLNB) performed. Methods In 2018, a retrospective study of 151 patients with malignant melanoma (MM) was conducted. The patients were hospitalized at the Second Clinic of University Hospital – Pleven, for the period 2012 to 2017. The patients were divided into two groups: Group A included 58 (38.4%) patients with SLNB performed; Group B included 93 (61.6%) patients who did not undergo SLNB. A double-detection method was used while performing SLNB. Results The incidence of achromatic malignant melanoma is significantly higher in patients without SLNB performed (12 or 12.9%), than in patients with SLNB performed (2 or 3.4%) – χ2 = 3.796, df = 1, p = 0.051. Of all 151 patients in the study, 46 died, representing 30.5 per 100 patients with melanoma. Mortality rate is higher in patients without SLNB (32.3% versus 27.6% in Group A). However, the differences in the two groups are not statistically significant. Conclusions Patients with achromatic melanoma have significantly fewer SLN biopsies performed because of a late diagnosis. Most of our patients are diagnosed at a later stage when lymphatic metastases are already present which leads to a significant increase in lymph node dissections performed. There is no significant difference in mortality and survival in the SLNB and non-SLNB groups.

scholarly journals Sentinel Node Biopsy after Neoadjuvant Chemotherapy for Breast Cancer: Preliminary Experience with Clinically Node Negative Patients after Systemic Treatment

2021 ◽  
Vol 11 (3) ◽  
pp. 172
Author(s):  
Alejandro Martin Sanchez ◽  
Daniela Terribile ◽  
Antonio Franco ◽  
Annamaria Martullo ◽  
Armando Orlandi ◽  
...  
Keyword(s):  
Lymph Node ◽  
False Negative ◽  
Neoadjuvant Treatment ◽  
Disease Free Survival ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Node Biopsy ◽  
Disease Free

Sentinel lymph node biopsy (SLNB) following neoadjuvant treatment (NACT) has been questioned by many studies that reported heterogeneous identification (IR) and false negative rates (FNR). As a result, some patients receive axillary lymph node dissection (ALND) regardless of response to NACT, leading to a potential overtreatment. To better assess reliability and clinical significance of SLNB status on ycN0 patients, we retrospectively analyzed oncological outcomes of 399 patients treated between January 2016 and December 2019 that were either cN0-ycN0 (219 patients) or cN1/2-ycN0 (180 patients). The Endpoints of our study were to assess, furthermore than IR: oncological outcomes as Overall Survival (OS); Distant Disease Free Survival (DDFS); and Regional Disease Free Survival (RDFS) according to SLNB status. SLN identification rate was 96.8% (98.2% in patients cN0-ycN0 and 95.2% in patients cN+-ycN0). A median number of three lymph nodes were identified and removed. Among cN0-ycN0 patients, 149 (68%) were confirmed ypN0(sn), whereas regarding cN1/2-ycN0 cases 86 (47.8%) confirmed an effective downstaging to ypN0. Three year OS, DDFS and RDFS were significantly related to SLNB positivity. Our data seemed to confirm SLNB feasibility following NACT in ycN0 patients, furthermore reinforcing its predictive role in a short observation timing.

Evaluating One Day versus Two Days Preoperative Lymphoscintigraphy Protocols for Sentinel Lymph Node Biopsy in Breast Cancer

2015 ◽  
Vol 81 (5) ◽  
pp. 454-457 ◽  
Author(s):  
Michael G. Mount ◽  
Nicholas R. White ◽  
Christophe L. Nguyen ◽  
Richard K. Orr ◽  
Robert B. Hird
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Axillary Lymph Node ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Axillary Lymph Node Metastases ◽  
Node Biopsy ◽  
Node Negative Breast Cancer

Sentinel lymph node biopsy (SLNB) is used to detect axillary lymph node metastases in breast cancer. Preoperative radiocolloid injection with lymphoscintigraphy (PL) is performed before SLNB. Few comparisons between 1- and 2-day PL protocols exist. Opponents of a 2-day protocol have expressed concerns of radiotracer washout to nonsentinel nodes. Proponents cite lack of scheduling conflicts between PL and surgery. A total of 387 consecutive patients with clinically node-negative breast cancer underwent SLNB with PL. Lymphoscintigraphy images were obtained within 30 minutes of radio-colloid injection. Axillary lymph node dissection was performed if the sentinel lymph node (SLN) could not be identified. Data were collected regarding PL technique and results. In all, 212 patients were included in the 2-day PL group and 175 patients in the 1-day PL group. Lymphoscintigraphy identified an axillary sentinel node in 143/212 (67.5%) of patients in the 2-day group and 127/175 (72.5%) in the 1-day group ( P = 0.28). SLN was identified at surgery in 209/212 (98.6%) patients in the 2-day group and 174/175 (99.4%) in the 1-day group ( P = 0.41). An average of 3 SLN was found at surgery in the 2-day group compared with 3.15 in the 1-day group ( P = 0.43). SLN was positive for metastatic disease in 54/212 (25.5%) patients in the 2-day group compared with 40/175 (22.9%) in the 1-day group ( P = 0.55). A 2-day lymphoscintigraphy protocol allows reliable detection of the SLN, of positive SLN and equivalent SLN harvest compared with a 1-day protocol. The timing of radiocolloid injection before SLNB can be left at the discretion of the surgeon.

scholarly journals Epitrochlear Lymph Node Dissection and Axillary Lymph Node Biopsy. An Unusual Clinical Presentation in a Patient with Forearm Melanoma

2013 ◽  
Vol 20 (13) ◽  
pp. 4378-4378 ◽  
Author(s):  
Piero Covarelli ◽  
Gian Marco Tomassini ◽  
Alessandra Servoli ◽  
Franco Picciotto ◽  
Giuseppe Noya
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Clinical Presentation ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Node Biopsy

Cost comparison of two surgical strategies in the treatment of breast cancer: Sentinel lymph node biopsy versus axillary lymph node dissection

2004 ◽  
Vol 20 (4) ◽  
pp. 449-454 ◽  
Author(s):  
Lionel Perrier ◽  
Karima Nessah ◽  
Magali Morelle ◽  
Hervé Mignotte ◽  
Marie-Odile Carrère ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Medical Costs ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Direct Medical Costs ◽  
Node Biopsy

Objectives: The feasibility and accuracy of sentinel lymph node biopsy (SLNB) in the treatment of breast cancer is widely acknowledged today. The aim of our study was to compare the hospital-related costs of this strategy with those of conventional axillary lymph node dissection (ALND).Methods: A retrospective study was carried out to determine the total direct medical costs for each of the two medical strategies. Two patient samples (n=43 for ALND; n=48 for SLNB) were selected at random among breast cancer patients at the Centre Léon Bérard, a comprehensive cancer treatment center in Lyon, France. Costs related to ALND carried out after SLNB (either immediately or at a later date) were included in SLNB costs (n=18 of 48 patients).Results: Total direct medical costs were significantly different in the two groups (median 1,965.86€ versus 1,429.93€, p=0.0076, Mann-Whitney U-test). The total cost for SLNB decreased even further for patients who underwent SLNB alone (median, 1,301€). Despite the high cost of anatomic pathology examinations and nuclear medicine (both favorable to ALND), the difference in direct medical costs for the two strategies was primarily due to the length of hospitalization, which differs significantly depending on the technique used (9-day median for ALND versus 3 days for SLNB, p<0.0001).Conclusions: A lower morbidity rate is favorable to the generalization of SLNB, when the patient's clinical state allows for it. From an economic point of view, SLNB also seems to be preferred, particularly because our results confirm those found in two published studies concerning the cost of SLNB.

scholarly journals Melanoma Inhibitory Activity and regional lymph node status in malignant melanoma patients

2015 ◽  
Vol 13 (Suppl 1) ◽  
pp. P11
Author(s):  
Angela Sandru ◽  
Silviu Voinea ◽  
Eugenia Panaitescu ◽  
Madalina Bolovan ◽  
Adina Stanciu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Malignant Melanoma ◽  
Inhibitory Activity ◽  
Regional Lymph Node ◽  
Lymph Node Status ◽  
Node Status ◽  
Melanoma Inhibitory Activity ◽  
Melanoma Patients
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