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
{"title":"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。","authors":"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","doi":"10.1186/s12957-025-03762-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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]).</p><p><strong>Conclusions: </strong>The present real-world data support omitting CLND in stage III CM with histologically documented sentinel nodal metastasis.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"111"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955116/pdf/","citationCount":"0","resultStr":"{\"title\":\"Completion of nodal dissection in cutaneous melanoma with metastatic sentinel nodes: Prognostic impact in a population-based cohort study.\",\"authors\":\"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\",\"doi\":\"10.1186/s12957-025-03762-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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]).</p><p><strong>Conclusions: </strong>The present real-world data support omitting CLND in stage III CM with histologically documented sentinel nodal metastasis.</p>\",\"PeriodicalId\":23856,\"journal\":{\"name\":\"World Journal of Surgical Oncology\",\"volume\":\"23 1\",\"pages\":\"111\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-03-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955116/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Surgical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12957-025-03762-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12957-025-03762-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Completion of nodal dissection in cutaneous melanoma with metastatic sentinel nodes: Prognostic impact in a population-based cohort study.
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.
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.
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