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Background <p>In primary cutaneous melanoma (CM) with metastatic sentinel lymph node(s) (SLNB), treatment strategies may include completing a regional lymph node dissection (CLND). The prognostic benefit of this therapeutic approach remains a topic of debate. This retrospective, population-based cohort study explores the prognostic impact of CLND in a real-world clinical setting.</p> Methods <p>This study analysed 280 incident cases of AJCC stage III CM with metastatic SLNB, as recorded by the Veneto population-based Regional Cancer Registry in 2015, 2017, and 2019. The overall survival and CM-specific survival rates were compared between patients who underwent CLND and those who did not. Kaplan-Meier analysis, Cox regression, and Fine-Gray models for competing risks tested the relationship between lymphadenectomy and overall and CM-specific survival.</p> Results <p>Among CM patients with metastatic SLNB, 199/280 (71.1%) proceeded with CLND. When compared to those who did not receive treatment, CLND did not demonstrate significant advantages in terms of overall survival and CM-specific survival rates. The cost analysis found no significant differences in treatment choice (estimated costs: €23,695.71 for the treated group and €25,003.55 for the untreated group [<i>p =</i> 0.69]).</p> Conclusions <p>The present real-world data support omitting CLND in stage III CM with histologically documented sentinel nodal metastasis.</p>

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Completion of nodal dissection in cutaneous melanoma with metastatic sentinel nodes: Prognostic impact in a population-based cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月29日

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  • Alessandra Buja,
  • Massimo Rugge,
  • Chiara Trevisiol,
  • Anna Zanovello,
  • Marcodomenico Mazza,
  • Luigi Dall’Olmo,
  • Manuel Zorzi,
  • Antonella Vecchiato,
  • Paolo Del Fiore,
  • Carlo Riccardo Rossi,
  • Simone Mocellin

摘要

Background

In primary cutaneous melanoma (CM) with metastatic sentinel lymph node(s) (SLNB), treatment strategies may include completing a regional lymph node dissection (CLND). The prognostic benefit of this therapeutic approach remains a topic of debate. This retrospective, population-based cohort study explores the prognostic impact of CLND in a real-world clinical setting.

Methods

This study analysed 280 incident cases of AJCC stage III CM with metastatic SLNB, as recorded by the Veneto population-based Regional Cancer Registry in 2015, 2017, and 2019. The overall survival and CM-specific survival rates were compared between patients who underwent CLND and those who did not. Kaplan-Meier analysis, Cox regression, and Fine-Gray models for competing risks tested the relationship between lymphadenectomy and overall and CM-specific survival.

Results

Among CM patients with metastatic SLNB, 199/280 (71.1%) proceeded with CLND. When compared to those who did not receive treatment, CLND did not demonstrate significant advantages in terms of overall survival and CM-specific survival rates. The cost analysis found no significant differences in treatment choice (estimated costs: €23,695.71 for the treated group and €25,003.55 for the untreated group [p = 0.69]).

Conclusions

The present real-world data support omitting CLND in stage III CM with histologically documented sentinel nodal metastasis.