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Impact of the time interval between lymph node recurrence and lymphadenectomy on melanoma patient survival

  • Therapy
  • Published:
European Journal of Dermatology

Abstract

Background

Lymphadenectomy is currently the standard treatment for melanoma patients with palpable lymph node (LN) metastasis. There is no recommendation as to the time when surgery should be performed in France.

Objectives

The aim of this retrospective study was to assess the impact of the time interval preceding lymphadenectomy on patient outcomes.

Materials & methods

Patients who underwent lymphadenectomy for LN macrometastasis (Stage IIIB/C AJCC) between 2005 and 2012 were included. Both the time interval between the first suspicion of LN recurrence (physical examination and imaging) and lymphadenectomy and the time interval between the multidisciplinary team meeting and lymphadenectomy were recorded. The impact of these time intervals on patient relapse-free survival (RFS) and overall survival (OS) were analysed. The regression optimized (ROP) model was used to identify ghost factors for the Cox model.

Results

A total of 154 patients were included. The median time interval between the multidisciplinary team meeting and lymphadenectomy was 22 days (IQR: 6 to 66). The median time interval between the first suspicion of LN recurrence and lymphadenectomy was 59 days (IQR: 15 to 676). Taking into account the effect identified by the regression optimized (ROP) model, these times were associated with an increased risk of recurrence and mortality (p<0.001 and p = 0.01, respectively).

Conclusion

Our study demonstrates that increasing the time interval preceding lymphadenectomy significantly reduces patient RFS and OS.

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Authors and Affiliations

  1. Department of Dermatology, CHU (Nantes University Hospital), Hôtel-Dieu, Nantes, 44093, France

    Sophie Vildy, Amir Khammari & Brigitte Dreno

  2. Department of Epidemiology and Biostatistics, CHU (Nantes University Hospital), Saint-Jacques, Nantes, 44093, France

    Jean-Michel Nguyen & Aurélie Gaultier

  3. Inserm, U892, CNRS, U6299, Hôtel-Dieu, Nantes, 44093, France

    Jean-Michel Nguyen, Anne-Chantal Knol, Amir Khammari & Brigitte Dreno

  4. Immunodermatology Laboratory, CHU (Nantes University Hospital), CIC, Hôtel-Dieu, Nantes, 44093, France

    Anne-Chantal Knol

Authors
  1. Sophie Vildy
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  2. Jean-Michel Nguyen
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  3. Aurélie Gaultier
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  4. Anne-Chantal Knol
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  5. Amir Khammari
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  6. Brigitte Dreno
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Corresponding author

Correspondence to Brigitte Dreno.

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Vildy, S., Nguyen, JM., Gaultier, A. et al. Impact of the time interval between lymph node recurrence and lymphadenectomy on melanoma patient survival. Eur J Dermatol 27, 166–173 (2017). https://doi.org/10.1684/ejd.2016.2955

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  • DOI: https://doi.org/10.1684/ejd.2016.2955

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