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Complete Lymph Node Dissection in Melanoma: A Systematic Review and Meta-Analysis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.ORCID iD: 0000-0001-9107-5814
Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
2017 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 37, no 12, p. 6825-6829Article, review/survey (Refereed) Published
Abstract [en]

Background: The aim of this meta-analysis was to estimate the survival after immediate complete lymph node dissection (CLND) compared to observation only (OO) or delayed CLND in patients with melanoma and lymph node metastasis.

Materials and Methods: A systematic search was performed in: PubMed, Web of Science, Cochrane Library, CINAHL, Clinical trials and Embase. Eligible studies were randomized controlled trials (RCTs) comparing: CLND with OO, or immediate CLND with delayed CLND.

Results: Four RCTs were included. There was no difference in melanoma-specific survival (MSS) (HR=0.91, 95% CI=0.77-1.08, p=0.29). In a sensitivity analysis, MSS was higher after immediate CLND compared to delayed CLND in patients with nodal metastasis (HR=0.63, 95% CI=0.35-0.74, p=0.0004) without evidence of heterogeneity.

Conclusion: CLND appears to have no additional survival benefit after SNB compared to OO. However, subgroup analysis suggests a time-dependent benefit for early surgical lymph node removal compared to delayed or none.

Place, publisher, year, edition, pages
2017. Vol. 37, no 12, p. 6825-6829
Keywords [en]
Complete lymph node dissection, melanoma, review
National Category
Cancer and Oncology Surgery
Identifiers
URN: urn:nbn:se:uu:diva-345600DOI: 10.21873/anticanres.12143ISI: 000417022100038PubMedID: 29187461OAI: oai:DiVA.org:uu-345600DiVA, id: diva2:1189516
Available from: 2018-03-12 Created: 2018-03-12 Last updated: 2018-03-12Bibliographically approved

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