Inefficacy of immediate node dissection in stage 1 melanoma of the limbs
U Veronesi, J Adamus, DC Bandiera, IO Brennhovd, E Caceres, N Cascinelli, F Claudio, RL Ikonopisov, VV Javorskj, S Kirov, A Kulakowski, J Lacoub, F Lejeune, Z Mechl, A Morabito, I Rode, S Sergeev, E van Slooten, K Szcygiel, and NN Trapeznikov
From September, 1967, to January, 1974, a clinical trial was carried out by the WHO Melanoma Group to evaluate the efficacy of elective lymph-node dissection in the treatment of malignant melanoma of the extremities with clinically uninvolved regional lymph nodes. Treatment was prospectively randomized: 267 patients to excision of primary melanoma and immediate regional-lymph-node dissection and 286 to excision of primary melanoma and regional-lymph-node dissection at the time of appearance of metastases. The statistical analysis showed no difference in survival between the two groups of patients, regardless of how the data were analyzed (according to sex, site of origin, maximum diameter of primary tumor or Clark's level or Breslow's thickness). Elective lymph-node dissection in malignant malanoma of the limbs does not improve the prognosis and is not recommended when patients can be followed at intervals of three months.
This article has been cited by other articles:
Voit, C. A., van Akkooi, A. C.J., Schafer-Hesterberg, G., Schoengen, A., Schmitz, P. I.M., Sterry, W., Eggermont, A. M.M.
(2009). Rotterdam Criteria for Sentinel Node (SN) Tumor Burden and the Accuracy of Ultrasound (US) -Guided Fine-Needle Aspiration Cytology (FNAC): Can US-Guided FNAC Replace SN Staging in Patients With Melanoma?. JCO
27: 4994-5000
[Abstract][Full Text]
Testori, A., Rutkowski, P., Marsden, J., Bastholt, L., Chiarion-Sileni, V., Hauschild, A., Eggermont, A. M. M.
(2009). Surgery and radiotherapy in the treatment of cutaneous melanoma. Ann Oncol
20: vi22-vi29
[Abstract][Full Text]
Wright, B. E., Scheri, R. P., Ye, X., Faries, M. B., Turner, R. R., Essner, R., Morton, D. L.
(2008). Importance of Sentinel Lymph Node Biopsy in Patients With Thin Melanoma. Arch Surg
143: 892-900
[Abstract][Full Text]
Markovic, S. N., Erickson, L. A., Rao, R. D., Weenig, R. H., Pockaj, B. A., Bardia, A., Vachon, C. M., Schild, S. E., McWilliams, R. R., Hand, J. L., Laman, S. D., Kottschade, L. A., Maples, W. J., Pittelkow, M. R., Pulido, J. S., Cameron, J. D., Creagan, E. T., Melanoma Study Group of the Mayo Clinic Cancer Cen,
(2007). Malignant Melanoma in the 21st Century, Part 2: Staging, Prognosis, and Treatment. Mayo Clin Proc.
82: 490-513
[Abstract][Full Text]
Morton, D. L., Thompson, J. F., Cochran, A. J., Mozzillo, N., Elashoff, R., Essner, R., Nieweg, O. E., Roses, D. F., Hoekstra, H. J., Karakousis, C. P., Reintgen, D. S., Coventry, B. J., Glass, E. C., Wang, H.-J., the MSLT Group,
(2006). Sentinel-node biopsy or nodal observation in melanoma.. NEJM
355: 1307-1317
[Abstract][Full Text]
Chen, S. L., Iddings, D. M., Scheri, R. P., Bilchik, A. J.
(2006). Lymphatic Mapping and Sentinel Node Analysis: Current Concepts and Applications. CA Cancer J Clin
56: 292-309
[Abstract][Full Text]
Kretschmer, L., Hilgers, R.
(2006). Research Supports the View that Sentinel Node Biopsy Is the Standard of Care in High-Risk Primary Melanoma. JCO
24: 2965-2966
[Full Text]
Zogakis, T. G., Essner, R., Wang, H.-j., Turner, R. R., Takasumi, Y. T., Gaffney, R. L., Lee, J. H., Morton, D. L.
(2005). Melanoma Recurrence Patterns After Negative Sentinel Lymphadenectomy. Arch Surg
140: 865-872
[Abstract][Full Text]
Lee, J. H., Essner, R., Torisu-Itakura, H., Wanek, L., Wang, H., Morton, D. L.
(2004). Factors Predictive of Tumor-Positive Nonsentinel Lymph Nodes After Tumor-Positive Sentinel Lymph Node Dissection for Melanoma. JCO
22: 3677-3684
[Abstract][Full Text]
Tsao, H., Atkins, M. B., Sober, A. J.
(2004). Management of Cutaneous Melanoma. NEJM
351: 998-1012
[Full Text]
Miranda, E. P., Gertner, M., Wall, J., Grace, E., Kashani-Sabet, M., Allen, R., Leong, S. P. L.
(2004). Routine Imaging of Asymptomatic Melanoma Patients With Metastasis to Sentinel Lymph Nodes Rarely Identifies Systemic Disease. Arch Surg
139: 831-837
[Abstract][Full Text]
Elias, N., Tanabe, K. K., Sober, A. J., Gadd, M. A., Mihm, M. C., Goodspeed, B., Cosimi, A. B.
(2004). Is Completion Lymphadenectomy After a Positive Sentinel Lymph Node Biopsy for Cutaneous Melanoma Always Necessary?. Arch Surg
139: 400-405
[Abstract][Full Text]
Lens, M. B., Dawes, M., Goodacre, T., Newton-Bishop, J. A.
(2002). Elective Lymph Node Dissection in Patients With Melanoma: Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Surg
137: 458-461
[Abstract][Full Text]
Patel, S. G., Coit, D. G., Shaha, A. R., Brady, M. S., Boyle, J. O., Singh, B., Shah, J. P., Kraus, D. H.
(2002). Sentinel Lymph Node Biopsy for Cutaneous Head and Neck Melanomas. Arch Otolaryngol Head Neck Surg
128: 285-291
[Abstract][Full Text]
Kanzler, M. H., Mraz-Gernhard, S.
(2001). Treatment of Primary Cutaneous Melanoma. JAMA
285: 1819-1821
[Full Text]
Gershenwald, J. E., Thompson, W., Mansfield, P. F., Lee, J. E., Colome, M. I., Tseng, C.-h., Lee, J. J., Balch, C. M., Reintgen, D. S., Ross, M. I.
(1999). Multi-Institutional Melanoma Lymphatic Mapping Experience: The Prognostic Value of Sentinel Lymph Node Status in 612 Stage I or II Melanoma Patients. JCO
17: 976-976
[Abstract][Full Text]
Thornton, H., Thomas, M., Beechey-Newman, N, Fentiman, I S, Young, A E, Dixon, J M.
(1999). Sentinel node biopsy in breast cancer. BMJ
318: 599-599
[Full Text]
Bostick, P., Essner, R., Glass, E., Kelley, M., Sarantou, T., Foshag, L. J., Qi, K., Morton, D.
(1999). Comparison of Blue Dye and Probe-Assisted Intraoperative Lymphatic Mapping in Melanoma to Identify Sentinel Nodes in 100 Lymphatic Basins. Arch Surg
134: 43-49
[Abstract][Full Text]
Piepkorn, M., Weinstock, M. A., Barnhill, R. L.
(1997). Theoretical and Empirical Arguments in Relation to Elective Lymph Node Dissection for Melanoma. Arch Dermatol
133: 995-1002
[Abstract]
Leong, S. P. L., Steinmetz, I., Habib, F. A., McMillan, A., Gans, J. Z., Allen, R. E. Jr, Morita, E. T., El-Kadi, M., Epstein, H. D., Kashani-Sabet, M., Sagebiel, R. W.
(1997). Optimal Selective Sentinel Lymph Node Dissection in Primary Malignant Melanoma. Arch Surg
132: 666-673
[Abstract]
Krag, D. N., Meijer, S. J., Weaver, D. L., Loggie, B. W., Harlow, S. P., Tanabe, K. K., Laughlin, E. H., Alex, J. C.
(1995). Minimal-Access Surgery for Staging of Malignant Melanoma. Arch Surg
130: 654-658
[Abstract]
Morton, D. L., Wen, D.-R., Wong, J. H., Economou, J. S., Cagle, L. A., Storm, F. K., Foshag, L. J., Cochran, A. J.
(1992). Technical Details of Intraoperative Lymphatic Mapping for Early Stage Melanoma. Arch Surg
127: 392-399
[Abstract]
Schneebaum, S., Briele, H. A., Walker, M. J., Greager, J., Wood, D. K., Ronan, S. G., Patel, M. K., Das Gupta, T. K.
(1987). Cutaneous Thick Melanoma: Prognosis and Treatment. Arch Surg
122: 707-711
[Abstract]
Cady, B.
(1984). Lymph Node Metastases: Indicators, but Not Governors of Survival. Arch Surg
119: 1067-1072
[Abstract]
Rogers, G. S., Kopf, A. W., Rigel, D. S., Friedman, R. J., Levine, J. L., Levenstein, M., Bart, R. S., Mintzis, M. M.
(1983). Effect of Anatomical Location on Prognosis in Patients With Clinical Stage I Melanoma. Arch Dermatol
119: 644-649
[Abstract]
Lew, R. A., Day, C. L. Jr, Harrist, T. J., Wood, W. C., Mihm, M. C. Jr
(1983). Multivariate Analysis: Some Guidelines for Physicians. JAMA
249: 641-643
[Abstract]
Roses, D. F., Harris, M. N., Gumport, S. L.
(1981). Surgical Management for Malignant Melanoma of the Trunk. Arch Surg
116: 315-317
[Abstract]
Karakousis, C. P., Seddiq, M. K., Moore, R.
(1980). Prognostic Value of Lymph Node Dissection in Malignant Melanoma. Arch Surg
115: 719-722
[Abstract]
WEISS, R. B., DeVITA, V. T. Jr.
(1979). Multimodal Primary Cancer Treatment (Adjuvant Chemotherapy): Current Results and Future Prospects. ANN INTERN MED
91: 251-260
[Abstract]
Huntington, H. W.
(1979). Journals in Jeopardy. JAMA
241: 1327-1327
[Abstract]