Ilioinguinal lymph node dissection for palpable metastatic melanoma to the groin

Allan, C. P., Hayes, A. J. and Thomas, J. M. (2008) Ilioinguinal lymph node dissection for palpable metastatic melanoma to the groin. The Australian and New Zealand Journal of Surgery, 78 11: 982-986. doi:10.1111/j.1445-2197.2008.04716.x


Author Allan, C. P.
Hayes, A. J.
Thomas, J. M.
Title Ilioinguinal lymph node dissection for palpable metastatic melanoma to the groin
Journal name The Australian and New Zealand Journal of Surgery   Check publisher's open access policy
ISSN 1445-1433
1445-2197
0004-8682
Publication date 2008-11
Sub-type Article (original research)
DOI 10.1111/j.1445-2197.2008.04716.x
Volume 78
Issue 11
Start page 982
End page 986
Total pages 5
Publisher Royal Australasian College of Surgeons
Language eng
Subject 1112 Oncology and Carcinogenesis
11 Medical and Health Sciences
Formatted abstract
Background: Block dissection of the inguinal lymph nodes is the routine management for palpable metastatic melanoma confined to this node basin. Involvement of the next tier external iliac and obturator lymph nodes in the pelvis is common, and untreated pelvic nodal disease can become advanced before becoming clinically apparent. We have routinely performed combined inguinal and pelvic (ilioinguinal) lymph node block dissection to avoid this morbid outcome.

Methods: A retrospective analysis of all patients undergoing ilioinguinal lymph node dissection for melanoma between January 1998 and January 2006 was carried out.

Results: There were 72 patients with a median age of 52.7 years (19.7–75.2 years) who were followed up for a median of 28.9 months (1.0–115.0 months) after ilioinguinal lymph node dissection. There were 22 (30.6%) of 72 patients with histologically involved pelvic lymph nodes. Preoperative computed tomography (CT) scanning accuracy for pelvic lymph node involvement was as follows: sensitivity 60.0%, specificity 100.0%, positive predictive value 100.0% and negative predictive value 86.2%. Lymphoedema was reported in 32 (44.4%) of 72 patients. Median time to first recurrence was 8.7 months (0.8–69.7 months). Regional recurrence occurred in 6 (8.3%) of 72 patients at a median of 4.9 months (0.9–32.0 months). Extranodal spread was the only factor adversely associated with disease-free survival. In all patients, 5-year disease-free survival was 38% (95% confidence interval (CI) 26–50) and overall survival 47% (95% CI 33–60).

Conclusion: Palpable metastatic melanoma in the groin is commonly associated with pelvic lymph node involvement, is not well predicted by CT scanning and is appropriately managed by ilioinguinal lymph node block dissection.
Keyword Groin
Lymph nodes
Melanoma
Pelvis
Malignant melanoma
Cutaneous melanoma
Prognostic factors
Randomized trial
Sentinel node
Stage-1
Q-Index Code C1
Q-Index Status Provisional Code
Additional Notes Journal also titled: ANZ Journal of Surgery

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Tue, 17 Nov 2009, 12:23:06 EST