Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Essner, R.
Right arrow Articles by Morton, D. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Essner, R.
Right arrow Articles by Morton, D. L.

Annals of Surgical Oncology, Vol 6, Issue 5 442-449, Copyright © 1999 by Society of Surgical Oncology

ARTICLES

Efficacy of lymphatic mapping, sentinel lymphadenectomy, and selective complete lymph node dissection as a therapeutic procedure for early-stage melanoma

R. Essner, A. Conforti, M. C. Kelley, L. Wanek, S. Stern, E. Glass and D. L. Morton
Roy E. Coats Research Laboratories of the John Wayne Cancer Institute, Santa Monica, California 90404, USA.

BACKGROUND: Lymphatic mapping, sentinel lymphadenectomy, and selective complete lymph node dissection (LM/SL/SCLND) is an increasingly popular alternative to elective lymphadenectomy (ELND) for patients with early-stage melanoma. Although several reports have demonstrated the accuracy of the LM/SL technique, there are no data on its therapeutic value. METHODS: We performed a matched-pair statistical analysis of 534 patients with clinical stage I melanoma; one half of the patients were treated with LM/SL and the other half were treated with ELND. Patients in the two treatment groups were matched for age (54% were < or =50 years of age), gender (63% were male patients), site of the primary melanoma (49% were on the extremities, 36% on the trunk, and 15% on the head and neck), and thickness of the primary melanoma (7% were < 0.75 mm, 42% between 0.75 and 1.5 mm, 43% between 1.51 and 4.0 mm, and 8% > 4 mm). Patients in the LM/SL group underwent complete regional lymphadenectomy (SCLND) only if the LM/SL specimen contained metastatic melanoma. RESULTS: The overall incidences of nodal metastases were no different (P = .18) between LM/SL (15.7%) and ELND (12%) groups, but the incidence of occult nodal disease was significantly (P = .025) higher among patients with intermediate-thickness (1.51-4.0-mm) primary tumors who underwent LM/SL (23.7%) instead of ELND (12.2%). Survival data were compared by the log-rank score test. LM/SL/SCLND and ELND resulted in equivalent 5-year rates of disease-free survival (79 +/- 3.3% and 84 +/- 2.2%, respectively; P = .25) and overall survival (88 +/- 3.0% and 86 +/- 2.1%, respectively; P = .98). The LM/SL and ELND groups also exhibited similar incidences of same-basin recurrences (4.8% vs. 2.1%, P = .10, respectively) and in-transit metastases (2.6% vs. 3.8%, P = .48) after tumor-negative dissections. Patients who underwent ELND showed a higher incidence of distant recurrences (8.9% vs. 4.0%, P = .03), but this may be related to the longer follow-up period for these patients (median, 169 months), compared with the LM/SL-treated patients (45 months). Among patients with tumor-positive nodal dissections, the 5-year overall survival rates were higher, and approached significance (P = .077) for patients treated by LM/SL/SCLND (64 +/- 12%) compared with ELND (45 +/- 10%). CONCLUSIONS: These findings suggest that LM/SL/SCLND is therapeutically equivalent to ELND but may be more effective for identifying nodal metastases in patients with intermediate-thickness primary tumors.


This article has been cited by other articles:


Home page
 JCOHome page
J. E. Gershenwald, R. H.I. Andtbacka, V. G. Prieto, M. M. Johnson, A. H. Diwan, J. E. Lee, P. F. Mansfield, J. N. Cormier, C. W. Schacherer, and M. I. Ross
Microscopic Tumor Burden in Sentinel Lymph Nodes Predicts Synchronous Nonsentinel Lymph Node Involvement in Patients With Melanoma
J. Clin. Oncol., September 10, 2008; 26(26): 4296 - 4303.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
Z. I. Nowecki, P. Rutkowski, and W. Michej
The Survival Benefit to Patients with Positive Sentinel Node Melanoma After Completion Lymph Node Dissection May Be Limited to the Subgroup with a Primary Lesion Breslow Thickness Greater Than 1.0 and Less Than or Equal to 4 mm (pT2-pT3)
Ann. Surg. Oncol., August 1, 2008; 15(8): 2223 - 2234.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
I. Satzger, B. Volker, A. Meier, A. Kapp, and R. Gutzmer
Criteria in Sentinel Lymph Nodes of Melanoma Patients that Predict Involvement of Nonsentinel Lymph Nodes
Ann. Surg. Oncol., June 1, 2008; 15(6): 1723 - 1732.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
K. M. Dalal, A. Patel, M. S. Brady, D. P. Jaques, and D. G. Coit
Patterns of First-Recurrence and Post-recurrence Survival in Patients with Primary Cutaneous Melanoma After Sentinel Lymph Node Biopsy
Ann. Surg. Oncol., June 1, 2007; 14(6): 1934 - 1942.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
J. F. Thompson, F. S. Hodi, and A. Zembowicz
Case 2-2007 -- A 49-Year-Old Woman with a Pigmented Lesion on the Arm
N. Engl. J. Med., January 18, 2007; 356(3): 285 - 292.
[Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
L. Kretschmer, I. Beckmann, K.-M. Thoms, C. Mitteldorf, H. P. Bertsch, and C. Neumann
Factors Predicting the Risk of In-Transit Recurrence After Sentinel Lymphonodectomy in Patients With Cutaneous Malignant Melanoma
Ann. Surg. Oncol., August 1, 2006; 13(8): 1105 - 1112.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
S. Mocellin, A. Ambrosi, M. C. Montesco, M. Foletto, G. Zavagno, D. Nitti, M. Lise, and C. R. Rossi
Support Vector Machine Learning Model for the Prediction of Sentinel Node Status in Patients With Cutaneous Melanoma
Ann. Surg. Oncol., August 1, 2006; 13(8): 1113 - 1122.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. R. Scoggins, M. I. Ross, D. S. Reintgen, R. D. Noyes, J. S. Goydos, P. D. Beitsch, M. M. Urist, S. Ariyan, B. S. Davidson, J. J. Sussman, et al.
Prospective Multi-Institutional Study of Reverse Transcriptase Polymerase Chain Reaction for Molecular Staging of Melanoma
J. Clin. Oncol., June 20, 2006; 24(18): 2849 - 2857.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
S. L. Wong, D. L. Morton, J. F. Thompson, J. E. Gershenwald, S. P. L. Leong, D. S. Reintgen, H. Gutman, M. S. Sabel, G. W. Carlson, K. M. McMasters, et al.
Melanoma Patients with Positive Sentinel Nodes Who Did Not Undergo Completion Lymphadenectomy: A Multi-Institutional Study
Ann. Surg. Oncol., June 1, 2006; 13(6): 809 - 816.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
A. Romanini, G. Manca, D. Pellegrino, R. Murr, S. Sarti, F. Bianchi, A. AlSharif, C. Orlandini, V. Zucchi, M. Castagna, et al.
Molecular staging of the sentinel lymph node in melanoma patients: correlation with clinical outcome
Ann. Onc., November 1, 2005; 16(11): 1832 - 1840.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
D. van Poll, J. F. Thompson, M. H. Colman, J. G. McKinnon, R. P. M. Saw, J. R. Stretch, R. A. Scolyer, and R. F. Uren
A Sentinel Node Biopsy Does Not Increase the Incidence of In-Transit Metastasis in Patients With Primary Cutaneous Melanoma
Ann. Surg. Oncol., August 1, 2005; 12(8): 597 - 608.
[Abstract] [Full Text] [PDF]

Home page
 Arch DermatolHome page
D. R. Berk, D. L. Johnson, A. Uzieblo, M. Kiernan, and S. M. Swetter
Sentinel Lymph Node Biopsy for Cutaneous Melanoma: The Stanford Experience, 1997-2004
Arch Dermatol, August 1, 2005; 141(8): 1016 - 1022.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
V. S.K. Yee, J. F. Thompson, J. G. McKinnon, R. A. Scolyer, L.-X. L. Li, W. H. McCarthy, C. J. O'Brien, M. J. Quinn, R. P.M. Saw, K. F. Shannon, et al.
Outcome in 846 Cutaneous Melanoma Patients From a Single Center After a Negative Sentinel Node Biopsy
Ann. Surg. Oncol., June 1, 2005; 12(6): 429 - 439.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
S. B. Kesmodel, G. C. Karakousis, J. D. Botbyl, R. J. Canter, R. T. Lewis, P. M. Wahl, K. P. Terhune, A. Alavi, D. E. Elder, M. E. Ming, et al.
Mitotic Rate as a Predictor of Sentinel Lymph Node Positivity in Patients With Thin Melanomas
Ann. Surg. Oncol., June 1, 2005; 12(6): 449 - 458.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
U. S. Kammula, R. Ghossein, S. Bhattacharya, and D. G. Coit
Serial Follow-Up and the Prognostic Significance of Reverse Transcriptase-Polymerase Chain Reaction--Staged Sentinel Lymph Nodes From Melanoma Patients
J. Clin. Oncol., October 1, 2004; 22(19): 3989 - 3996.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
A. Doubrovsky, J.H.W. de Wilt, R.A. Scolyer, W.H. McCarthy, and J.F. Thompson
Sentinel Node Biopsy Provides More Accurate Staging Than Elective Lymph Node Dissection in Patients With Cutaneous Melanoma
Ann. Surg. Oncol., September 1, 2004; 11(9): 829 - 836.
[Abstract] [Full Text] [PDF]

Home page
 CA Cancer J ClinHome page
C. M. Balch, S.-J. Soong, M. B. Atkins, A. C. Buzaid, N. Cascinelli, D. G. Coit, I. D. Fleming, J. E. Gershenwald, A. Houghton Jr., J. M. Kirkwood, et al.
An Evidence-based Staging System for Cutaneous Melanoma
CA Cancer J Clin, May 1, 2004; 54(3): 131 - 149.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
V. K. Sondak, J. M. G. Taylor, M. S. Sabel, Y. Wang, L. Lowe, A. C. Grover, A. E. Chang, A. M. Yahanda, J. Moon, and T. M. Johnson
Mitotic Rate and Younger Age Are Predictors of Sentinel Lymph Node Positivity: Lessons Learned From the Generation of a Probabilistic Model
Ann. Surg. Oncol., March 1, 2004; 11(3): 247 - 258.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
R. A. Scolyer, J. F. Thompson, L.-X. L. Li, A. Beavis, M. Dawson, P. Doble, V. S. K. Ka, J. Gregory McKinnon, R. Soper, R. F. Uren, et al.
Failure to Remove True Sentinel Nodes Can Cause Failure of the Sentinel Node Biopsy Technique: Evidence from Antimony Concentrations in False-Negative Sentinel Nodes from Melanoma Patients
Ann. Surg. Oncol., March 1, 2004; 11(3_suppl): 174S - 178S.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
S. P. L. Leong
Paradigm of Metastasis for Melanoma and Breast Cancer Based on the Sentinel Lymph Node Experience
Ann. Surg. Oncol., March 1, 2004; 11(3_suppl): 192S - 197S.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
J. M. Thomas, J. Newton-Bishop, R. A'Hern, G. Coombes, M. Timmons, J. Evans, M. Cook, J. Theaker, M. Fallowfield, T. O'Neill, et al.
Excision Margins in High-Risk Malignant Melanoma
N. Engl. J. Med., February 19, 2004; 350(8): 757 - 766.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
S. H. Estourgie, O. E. Nieweg, R. A. Valdes Olmos, C. A. Hoefnagel, and B. B. R. Kroon
Review and Evaluation of Sentinel Node Procedures in 250 Melanoma Patients With a Median Follow-Up of 6 Years
Ann. Surg. Oncol., July 1, 2003; 10(6): 681 - 688.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
R.J.C.L.M. Vuylsteke, P.A.M. van Leeuwen, M.G. S. Muller, H.A. Gietema, D.R. Kragt, and S. Meijer
Clinical Outcome of Stage I/II Melanoma Patients After Selective Sentinel Lymph Node Dissection: Long-Term Follow-Up Results
J. Clin. Oncol., March 15, 2003; 21(6): 1057 - 1065.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
K. M. McMasters, S. L. Wong, M. J. Edwards, C. Chao, M. I. Ross, R. D. Noyes, V. Viar, P. B. Cerrito, and D. S. Reintgen
Frequency of Nonsentinel Lymph Node Metastasis in Melanoma
Ann. Surg. Oncol., March 1, 2002; 9(2): 137 - 141.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
R. Essner and D. L. Morton
Does the Tumor Status of the Regional Lymph Nodes Really Matter in Melanoma?
Ann. Surg. Oncol., December 1, 2001; 8(10): 749 - 751.
[Full Text] [PDF]

Home page
 Arch DermatolHome page
R. W. Dubois, S. M. Swetter, M. Atkins, K. McMasters, R. Halbert, S. J. Miller, R. Shiell, and J. Kirkwood
Developing Indications for the Use of Sentinel Lymph Node Biopsy and Adjuvant High-Dose Interferon Alfa-2b in Melanoma
Arch Dermatol, September 1, 2001; 137(9): 1217 - 1224.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. M. Balch, A. C. Buzaid, S.-J. Soong, M. B. Atkins, N. Cascinelli, D. G. Coit, I. D. Fleming, J. E. Gershenwald, A. Houghton Jr, J. M. Kirkwood, et al.
Final Version of the American Joint Committee on Cancer Staging System for Cutaneous Melanoma
J. Clin. Oncol., August 15, 2001; 19(16): 3635 - 3648.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
K. M. McMasters, D. S. Reintgen, M. I. Ross, J. E. Gershenwald, M. J. Edwards, A. Sober, N. Fenske, F. Glass, C. M. Balch, and D. G. Coit
Sentinel Lymph Node Biopsy for Melanoma: Controversy Despite Widespread Agreement
J. Clin. Oncol., June 1, 2001; 19(11): 2851 - 2855.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
B. M. Clary, B. Mann, M. S. Brady, J. J. Lewis, and D. G. Coit
Early Recurrence After Lymphatic Mapping and Sentinel Node Biopsy in Patients With Primary Extremity Melanoma: A Comparison With Elective Lymph Node Dissection
Ann. Surg. Oncol., April 1, 2001; 8(4): 328 - 337.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
I. Pidhorecky, R. J. Lee, G. Proulx, D. R. Kollmorgen, C. Jia, D. L. Driscoll, W. G. Kraybill, and J. F. Gibbs
Risk Factors for Nodal Recurrence After Lymphadenectomy for Melanoma
Ann. Surg. Oncol., March 1, 2001; 8(2): 109 - 115.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J. A. de Hullu, H. Hollema, D. A. Piers, R. H. M. Verheijen, P. J. van Diest, M. J. E. Mourits, J. G. Aalders, and A. G. J. van der Zee
Sentinel Lymph Node Procedure Is Highly Accurate in Squamous Cell Carcinoma of the Vulva
J. Clin. Oncol., August 15, 2000; 18(15): 2811 - 2816.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1999 by the Society of Surgical Oncology.