Outcome after therapeutic lymph node dissection in patients with unknown primary melanoma site

Sebastiaan P. Prens, Augustinus P.T. Van Der Ploeg, Alexander C.J. Van Akkooi, Cornelis A.G.M. Van Montfort, Albertus N. Van Geel, Johannes H.W. De Wilt, Alexander M.M. Eggermont, Cornelis Verhoef

Onderzoeksoutput: Bijdrage aan tijdschriftArtikelpeer review

43 Citaten (Scopus)

Samenvatting

Purpose: The aim of this study was to evaluate the incidence and outcome of melanoma of unknown primary site (MUP) after therapeutic lymph node dissection (TLND) of palpable nodal melanoma metastases. Disease-free (DFS) and overall survival (OS) time of MUP patients were analyzed and compared to patients undergoing a TLND for known primary melanomas (MKP). Methods: This single institution retrospective study analyzed 342 consecutive patients who were treated with 415 TLNDs for palpable nodal disease from 1982 to 2009. Univariate and multivariate analyses included: MUP versus MKP, gender, Breslow thickness, ulceration of primary tumor, site of primary tumor, site of dissection, extracapsular extension, number of collected nodes, number of positive nodes and the node positive ratio. Results: A total of 47 MUP were identified in 342 patients (13.7%). In univariate analysis, a trend was seen toward better survival for MUP patients compared to MKP patients having 5-year OS rates of 40% and 27%, respectively (P = 0.06). Multivariate analysis for OS showed two highly significant factors associated with worse prognosis: extracapsular extension and N3 status (both P < 0.001). Two factors were associated with a significant better prognosis: MUP (P = 0.03) and a neck dissection (P = 0.04). Conclusions: Patients with MUP showed a statistically significant better OS compared to patients with melanoma metastases from known primary tumors. Presence of extracapsular extension and an increased number of positive nodes are statistically significantly negative prognostic factors for OS. The absence of a primary melanoma in stage III melanoma patients does not preclude surgery.

Originele taal-2Engels
Pagina's (van-tot)3586-3592
Aantal pagina's7
TijdschriftAnnals of Surgical Oncology
Volume18
Nummer van het tijdschrift13
DOI's
StatusGepubliceerd - dec. 2011
Extern gepubliceerdJa

Vingerafdruk

Duik in de onderzoeksthema's van 'Outcome after therapeutic lymph node dissection in patients with unknown primary melanoma site'. Samen vormen ze een unieke vingerafdruk.

Citeer dit