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Completion dissecti...
Completion dissection or observation for sentinel-node metastasis in melanoma
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- Faries, B. (author)
- Saint John's Health Center
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- Thompson, J. F. (author)
- University of California, Los Angeles
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- Cochran, Alistair J. (author)
- Jonsson Comprehensive Cancer Center
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- Andtbacka, R. H. (author)
- Huntsman Cancer Institute
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- Mozzillo, Nicola (author)
- Saint John's Health Center
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- Zager, J. S. (author)
- H. Lee Moffitt Cancer Center & Research Institute
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- Jahkola, Tiina (author)
- Helsinki University Central Hospital
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- Bowles, T. L. (author)
- Intermountain Medical Center
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- Testori, A (author)
- European Institute of Oncology
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- Beitsch, P. D. (author)
- Dallas Surgical Group
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- Hoekstra, H J (author)
- University Medical Center Groningen
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- Moncrieff, M. (author)
- Norfolk and Norwich University Hospital NHS Trust
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- Ingvar, C. (author)
- Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lunds Melanomstudiegrupp,Forskargrupper vid Lunds universitet,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Melanoma Study Group,Lund University Research Groups,Skåne University Hospital
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- Wouters, M. W. J. M. (author)
- Netherlands Cancer Institute
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- Sabel, M. S. (author)
- University of Michigan
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- Levine, E. A. (author)
- Wake Forest University
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- Agnese, D. (author)
- Ohio State University
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- Henderson, M (author)
- Peter MacCallum Cancer Centre
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- Dummer, R. (author)
- University of Zurich
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- Rossi-Alvarez, C (author)
- University of Padova
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- Neves, R. I. (author)
- Penn State Hershey Cancer Institute
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- Trocha, S. D. (author)
- Saint Louis University School of Medicine
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- Wright, Alan F (author)
- Tom Baker Cancer Centre
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- Byrd, D. R. (author)
- University of Washington
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- Matter, M. (author)
- Lausanne University Hospital
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- Hsueh, E. (author)
- Tom Baker Cancer Centre
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- MacKenzie-Ross, A. (author)
- Guy's and St Thomas' NHS Foundation Trust
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Johnson, D. B. (author)
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- Terheyden, P. (author)
- University Medical Center Schleswig-Holstein
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- Berger, A. C. (author)
- Thomas Jefferson University
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- Huston, T. L. (author)
- Sunnybrook Health Sciences Centre
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- Wayne, J. D. (author)
- Vanderbilt University
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- Smithers, B. M. (author)
- Princess Alexandra Hospital
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- Neuman, H. B. (author)
- Fox Chase Cancer Center
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- Schneebaum, S. (author)
- Greenville Health System Cancer Center (GHS)
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- Gershenwald, Jeffrey E (author)
- Klinikum Nürnberg
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- Ariyan, C. E. (author)
- Stony Brook University
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- Desai, D. C. (author)
- St. Luke's University Health Network
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- Jacobs, L. L. (author)
- Memorial Sloan-Kettering Cancer Center
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- McMasters, K. M. (author)
- Roswell Park Cancer Institute
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- Gesierich, A. (author)
- Northwestern University
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- Hersey, P (author)
- University of Wisconsin-Madison
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- Bines, S. D. (author)
- Rush University Medical Center Chicago
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- Kane, J. M. (author)
- Tel Aviv Sourasky Medical Center – Ichilov Hospital
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- Barth, R. J. (author)
- Dartmouth-Hitchcock Medical Center
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- McKinnon, G. (author)
- Johns Hopkins University School of Medicine
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- Farma, J. M. (author)
- University of Louisville
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- Schultz, E. (author)
- Hospital Clínic of Barcelona
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- Vidal-Sicart, Sergi (author)
- Anderson Medical Center
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- Hoefer, R. A. (author)
- Dartmouth-Hitchcock Medical Center
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- Lewis, Melanie J. (author)
- Sentara CarePlex Hospital
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- Scheri, R. (author)
- Newcastle Melanoma Unit
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- Kelley, M. C. (author)
- Istituto Nazionale Tumori IRCCS - Fondazione G Pascale, Napoli
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- Nieweg, Omgo E. (author)
- University of Sydney
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- Noyes, R. D. (author)
- Huntsman Cancer Institute
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- Hoon, Dave S. B. (author)
- Saint John's Health Center
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- Wang, H. J. (author)
- University of California, Los Angeles
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- Elashoff, D. A. (author)
- University of California, Los Angeles
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- Elashoff, R. M. (author)
- University of California, Los Angeles
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(creator_code:org_t)
- 2017
- 2017
- English 12 s.
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In: New England Journal of Medicine. - 0028-4793. ; 376:23, s. 2211-2222
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND Sentinel-lymph-node biopsy is associated with increased melanoma-specific survival (i.e., survival until death from melanoma) among patients with node-positive intermediatethickness melanomas (1.2 to 3.5 mm). The value of completion lymph-node dissection for patients with sentinel-node metastases is not clear. METHODS In an international trial, we randomly assigned patients with sentinel-node metastases detected by means of standard pathological assessment or a multimarker molecular assay to immediate completion lymph-node dissection (dissection group) or nodal observation with ultrasonography (observation group). The primary end point was melanoma-specific survival. Secondary end points included disease-free survival and the cumulative rate of nonsentinel-node metastasis. RESULTS Immediate completion lymph-node dissection was not associated with increased melanomaspecific survival among 1934 patients with data that could be evaluated in an intention-Totreat analysis or among 1755 patients in the per-protocol analysis. In the per-protocol analysis, the mean (-SE) 3-year rate of melanoma-specific survival was similar in the dissection group and the observation group (86-1.3% and 86-1.2%, respectively; P = 0.42 by the logrank test) at a median follow-up of 43 months. The rate of disease-free survival was slightly higher in the dissection group than in the observation group (68-1.7% and 63-1.7%, respectively; P = 0.05 by the log-rank test) at 3 years, based on an increased rate of disease control in the regional nodes at 3 years (92-1.0% vs. 77-1.5%; P<0.001 by the log-rank test); these results must be interpreted with caution. Nonsentinel-node metastases, identified in 11.5% of the patients in the dissection group, were a strong, independent prognostic factor for recurrence (hazard ratio, 1.78; P = 0.005). Lymphedema was observed in 24.1% of the patients in the dissection group and in 6.3% of those in the observation group. CONCLUSIONS Immediate completion lymph-node dissection increased the rate of regional disease control and provided prognostic information but did not increase melanoma-specific survival among patients with melanoma and sentinel-node metastases.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Faries, B.
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Thompson, J. F.
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Cochran, Alistai ...
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Andtbacka, R. H.
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Mozzillo, Nicola
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Zager, J. S.
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show more...
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Jahkola, Tiina
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Bowles, T. L.
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Testori, A
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Beitsch, P. D.
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Hoekstra, H J
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Moncrieff, M.
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Ingvar, C.
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Wouters, M. W. J ...
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Sabel, M. S.
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Levine, E. A.
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Agnese, D.
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Henderson, M
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Dummer, R.
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Rossi-Alvarez, C
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Neves, R. I.
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Trocha, S. D.
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Wright, Alan F
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Byrd, D. R.
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Matter, M.
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Hsueh, E.
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MacKenzie-Ross, ...
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Johnson, D. B.
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Terheyden, P.
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Berger, A. C.
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Huston, T. L.
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Wayne, J. D.
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Smithers, B. M.
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Neuman, H. B.
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Schneebaum, S.
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Gershenwald, Jef ...
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Ariyan, C. E.
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Desai, D. C.
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Jacobs, L. L.
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McMasters, K. M.
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Gesierich, A.
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Hersey, P
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Bines, S. D.
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Kane, J. M.
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Barth, R. J.
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McKinnon, G.
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Farma, J. M.
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Schultz, E.
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Vidal-Sicart, Se ...
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Hoefer, R. A.
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Lewis, Melanie J ...
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Scheri, R.
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Kelley, M. C.
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Nieweg, Omgo E.
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Noyes, R. D.
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Hoon, Dave S. B.
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Wang, H. J.
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Elashoff, D. A.
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Elashoff, R. M.
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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New England Jour ...
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Lund University