Portal de Periódicos da CAPES

Is Completion Lymph Node Dissection Needed in Case of Minimal Melanoma Metastasis in the Sentinel Node?

2009; Lippincott Williams & Wilkins; Volume: 249; Issue: 6 Linguagem: Inglês

10.1097/sla.0b013e3181a77eba

1528-1140

Iris M. C. van der Ploeg, Bin B. R. Kroon, Ninja Antonini, Renato A. Valdés Olmos, Omgo E. Nieweg,

Melanoma and MAPK Pathways

The purpose of this study was to evaluate the micromorphometric Starz-classification in melanoma patients.The micromorphometric Starz-classification suggests that melanoma patients with a sentinel node metastasis invading no more than 0.3 mm (S-I) or 0.31 to 1.0 mm (S-II) below the capsular level can be spared further surgery, while invasion of the metastasis of more than 1.0 mm (S-III) implies a need for completion dissection.Seventy patients with sentinel node metastases were studied. Twenty patients with an S-I or S-II classification were spared further surgery and 50 S-III patients underwent completion dissection. The median follow-up time was 33 months.No lymph node recurrences were detected in the 20 S-I, II patients. Six of the 50 S-III patients (12%) had additional involved nodes in the dissection specimen. In these patients no recurrences developed in the cleared regional basins. Overall 3-year survival was 100% in the S-I, II patients and 80% in the S-III patients (P = 0.04). Three-year disease-free survival rates were 83% and 60%, respectively (P = 0.40).: This study suggests that further surgery is unnecessary in S-I and S-II patients, while it does seem prudent to carry out completion dissection in S-III patients. The distinct survival difference between the 2 groups of patients suggests that the S-classification also has prognostic implications.