A Rational Approach to the Surgical Management of Melanoma

Holmes, E. Carmack; Moseley, H. Stephens; Morton, Donald L.; Clark, Wallace H.; Robinson, David S.; Urist, Marshall M.

doi:10.1097/00000658-197710000-00010

Cited by 174 publications

(56 citation statements)

References 9 publications

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“…16,18,20,22,[26][27][28] Two studies used water displacement methods exclusively for limb volume assessment, defining lymphedema thresholds of 6.5% and 10%, 29,30 and another 4 studies used both circumference and water displacement. 23,[31][32][33] More subjective assessments of lymphedema included the Common Toxicity Criteria and the Late Effects Normal Tissues Scales, 34,35 but the majority used ad hoc clinical grading to define lymphedema such as skin-pinch tests or scales defined by the treating physician.…”

Section: Methods Of Lymphedema Assessmentmentioning

confidence: 99%

Lymphedema beyond breast cancer

Cormier

Askew

Mungovan

et al. 2010

Cancer

416

170

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BACKGROUND: Secondary lymphedema is a debilitating, chronic, progressive condition that commonly occurs after the treatment of breast cancer. The purpose of the current study was to perform a systematic review and meta-analysis of the oncology-related literature excluding breast cancer to derive estimates of lymphedema incidence and to identify potential risk factors among various malignancies. METHODS: The authors systematically reviewed 3 major medical indices (MEDLINE, Cochrane Library databases, and Scopus) to identify studies that included a prospective assessment of lymphedema after cancer treatment. Studies were categorized according to malignancy, and data included treatment, complications, lymphedema measurement criteria, lymphedema incidence, and followup interval. A quality assessment of individual studies was performed using established criteria for systematic reviews. Bayesian meta-analytic techniques were applied to derive summary estimates when sufficient data were available. RESULTS: A total of 47 studies (7779 cancer survivors) met inclusion criteria: melanoma (n ¼ 15), gynecologic malignancies (n ¼ 22), genitourinary cancers (n ¼ 8), head/neck cancers (n ¼ 1), and sarcomas (n ¼ 1). The overall incidence of lymphedema was 15.5% and varied by malignancy (P < .001): melanoma, 16% (upper extremity, 5%; lower extremity, 28%); gynecologic, 20%; genitourinary, 10%; head/neck, 4%; and sarcoma, 30%. Increased lymphedema risk was also noted for patients undergoing pelvic dissections (22%) and radiation therapy (31%). Objective measurement methods and longer follow-up were both associated with increased lymphedema incidence. CONCLUSIONS: Lymphedema is a common condition affecting cancer survivors with various malignancies. The incidence of lymphedema is related to the type and extent of treatment, anatomic location, heterogeneity of assessment methods, and length of follow-up. Cancer 2010;116:5138-49.

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Section: Methods Of Lymphedema Assessmentmentioning

confidence: 99%

Lymphedema beyond breast cancer

Cormier

Askew

Mungovan

et al. 2010

Cancer

416

170

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“…Lymphoscintigraphy has been shown to be a valuable radiotogic technique in predicting lymphatic drainage in patients with cutaneous melanoma (17). It has been shown to be more reliable in identifying lymph node basins at risk for metastasis than standard anatomical guidelines (18).…”

Section: Preoperative Lymphoscintigraphymentioning

confidence: 99%

“…We used a technique recently introduced for melanoma patients, selective lymphadenectomy or sentinel node (SLN) biopsy, to identify lymph node basins at risk for metastasis (14)(15)(16)(17)(18). The procedure is based on identification of the first lymph node draining the primary minor site, the sentinel node, by preoperative and intraoperative mapping of lymphatic channels (14)(15)(16)(17). It has been shown that the histopathology of the sentinel node reflects, with a high degree of accuracy, the histology of the remaining nodes in the basin (15,16).…”

mentioning

confidence: 99%

Selective lymphadenectomy in patients with Merkel cell (cutaneous neuroendocrine) carcinoma

Messina

Reintgen

Cruse

et al. 1997

Annals of Surgical Oncology

148

100

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“…Depending on the primary melanoma's anatomic site, some patients may be at risk for metastasis to more than one lymph node basin. Ambiguous or dual-basin drainage patterns, especially from primary tumors on the head, neck, or trunk, have been documented in lymphoscintigraphic studies (1)(2)(3). Two previous reports estimate the incidence of dual-basin metastasis at 5-12% (4,5).…”

mentioning

confidence: 99%

Metastasis of primary melanoma to two separate lymph node basins: Prognostic significance

Dale

Foshag

Wanek

et al. 1997

Annals of Surgical Oncology

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The survival rate of melanoma patients with regional metastases in two lymph node basins is lower than that of patients with an equal tumor burden confined to a single basin. This suggests that primary melanomas metastasizing to more than one lymph node basin may have a higher metastatic potential, or that dual-basin involvement may increase the risk of systemic spread. We advocate lymphatic mapping, sentinel node biopsy, and selective lymphadenectomy as a cost-effective technique with little morbidity to identify and manage occult metastases in patients who have two lymph basins at risk.

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A Rational Approach to the Surgical Management of Melanoma

Cited by 174 publications

References 9 publications

Lymphedema beyond breast cancer

Lymphedema beyond breast cancer

Selective lymphadenectomy in patients with Merkel cell (cutaneous neuroendocrine) carcinoma

Metastasis of primary melanoma to two separate lymph node basins: Prognostic significance

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