Completion of nodal dissection in cutaneous melanoma with metastatic sentinel nodes: Prognostic impact in a population-based cohort study.

IF 2.5 3区医学 Q3 ONCOLOGY

World Journal of Surgical Oncology Pub Date : 2025-03-29 DOI:10.1186/s12957-025-03762-w

Alessandra Buja, Massimo Rugge, Chiara Trevisiol, Anna Zanovello, Marcodomenico Mazza, Luigi Dall'Olmo, Manuel Zorzi, Antonella Vecchiato, Paolo Del Fiore, Carlo Riccardo Rossi, Simone Mocellin

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引用次数: 0

Abstract

Background: In primary cutaneous melanoma (CM) with metastatic sentinel lymph node(s) (SLNB), treatment strategies may include completing a regional lymph node dissection (CLND). The prognostic benefit of this therapeutic approach remains a topic of debate. This retrospective, population-based cohort study explores the prognostic impact of CLND in a real-world clinical setting.

Methods: This study analysed 280 incident cases of AJCC stage III CM with metastatic SLNB, as recorded by the Veneto population-based Regional Cancer Registry in 2015, 2017, and 2019. The overall survival and CM-specific survival rates were compared between patients who underwent CLND and those who did not. Kaplan-Meier analysis, Cox regression, and Fine-Gray models for competing risks tested the relationship between lymphadenectomy and overall and CM-specific survival.

Results: Among CM patients with metastatic SLNB, 199/280 (71.1%) proceeded with CLND. When compared to those who did not receive treatment, CLND did not demonstrate significant advantages in terms of overall survival and CM-specific survival rates. The cost analysis found no significant differences in treatment choice (estimated costs: €23,695.71 for the treated group and €25,003.55 for the untreated group [p = 0.69]).

Conclusions: The present real-world data support omitting CLND in stage III CM with histologically documented sentinel nodal metastasis.

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具有转移前哨淋巴结的皮肤黑色素瘤淋巴结清扫的完成：一项基于人群的队列研究的预后影响。

背景：原发性皮肤黑色素瘤（CM）伴有转移性前哨淋巴结（SLNB），治疗策略可能包括完成区域淋巴结清扫（CLND）。这种治疗方法的预后益处仍然是一个有争议的话题。这项回顾性的、基于人群的队列研究探讨了CLND在现实世界临床环境中的预后影响。方法：本研究分析了2015年、2017年和2019年威尼托人口为基础的区域癌症登记处记录的280例AJCC III期CM合并转移性SLNB病例。比较接受CLND和未接受CLND的患者的总生存率和cm特异性生存率。Kaplan-Meier分析、Cox回归和竞争风险的Fine-Gray模型检验了淋巴结切除术与总生存率和cm特异性生存率之间的关系。结果：在伴有转移性SLNB的CM患者中，199/280（71.1%）进行了CLND。与未接受治疗的患者相比，CLND在总生存率和cm特异性生存率方面没有显着优势。成本分析发现治疗选择没有显著差异（估计成本：治疗组为23,695.71欧元，未治疗组为25,003.55欧元[p = 0.69]）。结论：目前的真实数据支持在组织学记录的前哨淋巴结转移的III期CM中省略CLND。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.