Das inguinale Rezidiv nach therapeutischer Lymphadenektomie beim malignen Melanom

✍ Scribed by L. Kretschmer; C. Lautenschläger; K. -P. Preulβr; H. Fiedler

• Publisher: Springer
• Year: 1993
• Tongue: English
• Weight: 661 KB
• Volume: 378
• Category: Article
• ISSN: 1435-2451
• DOI: 10.1007/bf00184363

✦ Synopsis

In a retrospective study, 73 stage-II melanoma patients with 22 superficial and 51 deep groin dissections were observed over a maximum of 9 years of follow up (median 67.5 months). The 5-year survival rate of 29.8 % was consistent with that yielded by comparable analyses of other investigators. However, the probability of recurrence in the node dissection field was as high as 35%. All groin recurrences occurred in the first 29 months after lymph node clearance (median 6 months). Patients with groin recurrence following lymph-node dissection had a poor prognosis (median survival 12 months). In a multifactorial analysis (Cox model), the only prognostic factor of probability of recurrence was the development of regional in-transit cutaneous metastases (p = 0.0028). Factors that did not affect the appearance of recurrent metastases in the node dissection field were: site of primary melanoma, tumor thickness, epidermal ulceration, degree of lymph node involvement (p = 0.2) age, sex, degree of surgery (superficial or deep groin dissection) and adjuvant chemotherapy. Because regional in-transit cutaneous metastases mostly occur synchronously with groin recurrence or later, they are a typical concomitant phenomenon rather than a prognostic factor of recurrence.