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Sentinel node biopsy and radical lymph node dissection for advanced melanoma in the elderly

Authors
Journal
BMC Geriatrics
1471-2318
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Volume
11
Identifiers
DOI: 10.1186/1471-2318-11-s1-a9
Keywords
  • Meeting Abstract
Disciplines
  • Biology
  • Medicine

Abstract

Sentinel node biopsy and radical lymph node dissection for advanced melanoma in the elderly MEETING ABSTRACT Open Access Sentinel node biopsy and radical lymph node dissection for advanced melanoma in the elderly V Desiato*, S Perrotta, GL Benassai, G Quarto, G Benassai, G Limite From XXIII Annual Meeting of the Italian Society of Geriatric Surgery Lecce, Italy. 2-4 December 2010 Background The majority of indications for surgery in melanoma are for the treatment of primary tumor and lymph node metastases. During the last decade, the Sentinel Node Biopsy (SNB), from a research procedure, has become standard of care in most institutions. SNB is normally considered for patients with melanoma > 1 mm and generally about 20% are positive; however, the risk of a positive SNB in a melanoma < 1 mm is still 5%. Usually when SNB is positive a complete lymphadenectomy is performed. Materials and methods In the period 2004-2009, 18 elderly patients (median age 68 years) affected by cutaneous melanoma (mean Bre- slow’s thickness = 3.77 mm), after SNB histologically confirmed regional lymph node involvement, underwent complete lymph node dissection (CLND). We treated 11 of them with groin dissection, in 3 cases bilateral; 4 patients underwent axillar dissection, in one case bilat- eral; 2 patients underwent neck dissection and another patient underwent groin-axillar dissection. We treated bilateral groin involvement with laparoscopic access for dissection of lumbar-aortic, iliac and obturator lymph nodes. Results Disagreeing with literature, 12/18 (67%) of these patients had positive lymph nodes, a high percentage if com- pared with younger patients’ data. Currently the average follow-up is 25 months. In our sample CLND has a cru- cial prognostic role (16% vs 41% of deceased in CLND – and CLND + patients respectively). Conclusions Elderly melanoma patients are characterized by a higher tumor stage and, in patients with nodal metastases, the prognosis is independently affected by older ag

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