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Robotic-Assisted Pelvic Lymphadenectomy for Metastatic Melanoma Results in Durable Oncologic Outcomes

  • Melanoma
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Abstract

Background

Robotic pelvic lymphadenectomy (rPLND) has been demonstrated to be a safe and effective minimally invasive approach for patients with metastatic melanoma to the iliac nodes. However, the long-term oncologic benefit of this procedure remains poorly defined.

Methods

A single-institutional study comparing perioperative outcomes and survival [recurrence-free (RFS) and overall survival (OS)] between rPLND and open PLND (oPLND) for metastatic melanoma was conducted.

Results

From 2006 to 2018, a total of 63 PLND cases were identified: 22 rPLND and 41 oPLND. Evidence of isolated pelvic metastasis was the most common indication for PLND in both groups (rPLND: 64%, oPLND: 85%). There was no difference in median pelvic lymph node yield (11 vs. 9 nodes, p = 0.65). Neither treatment group experienced a Clavien-Dindo complication ≥ 3. rPLND was associated with a shorter length of stay compared with oPLND (2 vs. 4 days, p < 0.001). With a median follow-up of 37 months, there was no difference in RFS (14.4 vs. 9.6 months, p = 0.47) and OS (43 vs. 50 months, p = 0.58) between rPLND and oPLND, respectively. In basin recurrence was low with 1 (4.5%) and 3 (7.3%) patients in the rPLND and oPLND cohorts, respectively, experiencing an event (p = 0.9).

Conclusions

rPLND for metastatic melanoma is a safe, minimally invasive treatment strategy that appears to result in similar intermediate term recurrence and survival rates as oPLND but shorter hospital stays.

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Authors and Affiliations

  1. Department of Cutaneous Oncology, Moffitt Cancer Center and Research Institute, University of South Florida School of Medicine, 10920 N. McKinley Drive, Room 4123, Tampa, FL, 33612, USA

    John T. Miura MD, Aishwarya Potdar BS, Hala Daou BS, James Sun MD, Amod A. Sarnaik MD & Jonathan S. Zager

  2. Department of Surgery, Rogel Cancer Center University of Michigan, Ann Arbor, MI, USA

    Lesly A. Dossett MD

  3. Department of Biostatistics and Bioinformatics, Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Ram Thapa PhD & Youngchul Kim PhD

Authors
  1. John T. Miura MD
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  2. Lesly A. Dossett MD
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  3. Ram Thapa PhD
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  4. Youngchul Kim PhD
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  5. Aishwarya Potdar BS
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  6. Hala Daou BS
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  7. James Sun MD
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  9. Jonathan S. Zager
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Correspondence to Jonathan S. Zager.

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Miura, J.T., Dossett, L.A., Thapa, R. et al. Robotic-Assisted Pelvic Lymphadenectomy for Metastatic Melanoma Results in Durable Oncologic Outcomes. Ann Surg Oncol 27, 196–202 (2020). https://doi.org/10.1245/s10434-019-07333-8

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  • DOI: https://doi.org/10.1245/s10434-019-07333-8

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