Abubakr Ahmed, Gaitri Sadadcharam, Felicity Huisma, Katrina Fogarty, Muhammad Mushtaque, Azher Shafiq, Paul Redmond
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引用次数: 13
摘要
背景。虽然淋巴结清扫术后并发症很常见,但其与疾病复发的关系尚未得到充分的研究。方法。对一个前瞻性维护的数据库进行了回顾性审查,研究了2002年至2011年间所有需要腋窝或腹股沟清扫的前哨淋巴结阳性恶性黑色素瘤患者。结果。317例接受前哨淋巴结活检的I/II期恶性黑色素瘤患者中,共有124例患者需要淋巴结清除。其中104例患者符合纳入标准,分为腹股沟淋巴结清扫组(ILND;n = 63)或腋窝淋巴结清扫(ALND;N = 41)。免疫组化沉积对ALND的检出率较高(P = 0.01)。ILND患者复发率较高(84.1% vs . 63.4%;P = 0.02)和死亡率(68.3% vs 48.8%;P = 0.05),并发症发生率无显著差异。在出现并发症的患者中,75%的ILND组和71.4%的ALND组有疾病复发,但没有达到作为黑色素瘤复发的独立预测因子的统计值。结论。ILND和ALND的并发症很常见;两组间并发症发生率无显著性差异,且与复发有一定关系,但无显著性差异。
Postoperative Complications following Nodal Dissection and Their Association with Melanoma Recurrence.
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; n = 63) or axillary lymph node dissections (ALND; n = 41). Immunohistochemical deposits had higher detection rate in ALND (P = 0.01). The ILND patients had a higher recurrence rate (84.1% versus 63.4%; P = 0.02) and mortality (68.3% versus 48.8%; P = 0.05) 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.