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A prospective randomized study of the efficacy of routine elective lymphadenectomy in management of malignant melanoma. Preliminary results
Author(s) -
Sim Franklin H.,
Taylor William F.,
Ivins John C.,
Pritchard Douglas J.,
Soule Edward H.
Publication year - 1978
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197803)41:3<948::aid-cncr2820410324>3.0.co;2-z
Subject(s) - medicine , lymphadenectomy , melanoma , dissection (medical) , randomized controlled trial , surgery , prospective cohort study , lymph node , stage (stratigraphy) , metastasis , cancer , paleontology , cancer research , biology
To determine whether immediate or delayed lymphadenectomy is more beneficial than none in cases of localized (stage I) melanoma, we undertook in 1972 a prospective randomized study. Patients with midline trunk lesions were excluded as well as patients with lesions situated directly over the node‐bearing area. In addition, because of the low risk of metastasis, the protocol was changed to exclude level 2 lesions. Of the 173 patients studied, 63 were randomized to no lymphadenectomy, 56 to delayed (3 months) lymphadenectomy, and 54 to immediate lymphadenectomy. None of these regimens differed significantly from the others in its effect on length of survival or interval to metastasis. And of the 110 patients who underwent elective lymphadenectomy, 103 were without nodal involvement. Our preliminary conclusion is that elective node dissection is not beneficial in management of melanoma. However, disease progression was advanced significantly by age of the patient (>60 years) and by invasiveness (level 4 or 5) and thickness (>1.5 mm) of the melanoma.