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Cirugía y cirujanos
versión On-line ISSN 2444-054Xversión impresa ISSN 0009-7411
Resumen
AVILES-IZQUIERDO, José A. et al. When is it worth performing lymphadenectomy in patients with melanoma micrometastases? A 20-year experience retrospective analysis. Cir. cir. [online]. 2021, vol.89, n.4, pp.457-460. Epub 03-Nov-2021. ISSN 2444-054X. https://doi.org/10.24875/ciru.20000545.
Background:
The benefits of complete lymph node dissection (CLND) in melanoma patients with a positive sentinel lymph node biopsy (SLNB) have been recently questioned. Sentinel node (SN) tumor burden > 1 mm has been proposed as the most reliable parameter associated with positive CLND and poorer disease-free survival.
Material and methods:
Between June 1997 and June 2017, data from 119 melanoma patients with positive SLNB were analyzed. Patients were classified by SN burden in two groups: ≤ 1 mm and > 1 mm.
Results:
CLND was positive in 6 (10%) patients with SN tumor burden ≤ 1 mm and in 23 (37.7%) patients with > 1 mm (p < 0.001). In univariable analysis, SN tumor burden was the only predictive factor of positive CLND (OR 5.24 [1.94-14.13]). In multivariable analysis, SN tumor burden was the only independent factor of melanoma-specific survival (MSS).
Conclusion:
Although CLND should still be considered individually in patients with positive SLNB, SN tumor burden >1 mm might be a good predictive factor of additional positive non-sentinel nodes and a strong independent prognostic factor in melanoma-specific survival.
Palabras llave : Melanoma; Sentinel lymph node biopsy; Lymphadenectomy; Micrometastasis; Survival analysis; Melanoma-specific survival.