Inguinal and Ilio-inguinal Lymphadenectomy in Management of Palpable Melanoma Lymph Node Metastasis: A Long-Term Prospective Evaluation of Morbidity and Quality of Life
| Autor: | Bryan Burmeister, John F. Thompson, João Pedreira Duprat, Michael A. Henderson, David E. Gyorki, Jill Ainslie, Kerwin F. Shannon, Bernard Mark Smithers, Angela Hong, Richard Fisher, Scott Carruthers, Scott Babington, J. Di Iulio, Harald J. Hoekstra, Brendon J. Coventry, Richard A. Scolyer |
|---|---|
| Přispěvatelé: | Organizational Psychology |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Inguinal Canal Ilium 03 medical and health sciences 0302 clinical medicine Quality of life Surgical oncology Humans Medicine Prospective Studies Prospective cohort study Melanoma DISSECTION Survival rate Aged RISK COMPLICATIONS business.industry Hazard ratio Disease Management Middle Aged Prognosis Inguinal canal Surgery Survival Rate Dissection medicine.anatomical_structure Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis SURGICAL-MANAGEMENT Quality of Life BIOPSY Lymph Node Excision Female 030211 gastroenterology & hepatology Lymphadenectomy Lymph Nodes Morbidity business Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology, 26(13), 4663-4672. SPRINGER |
| ISSN: | 1534-4681 1068-9265 |
| Popis: | Purpose. Prospective data are lacking on long-term morbidity of inguinal lymphadenectomy including the influence of extent of surgery, use of radiotherapy, and patient factors. The aim of this study is to evaluate the effects of these factors on patient outcome, quality of life (QOL), regional symptoms, and limb volumes after inguinal or ilio-inguinal lymphadenectomy for melanoma.Methods. Analysis of the subgroup of patients with inguinal lymph node field relapse of melanoma, treated by inguinal or ilio-inguinal lymphadenectomy in the ANZMTG/TROG randomized trial of adjuvant radiotherapy versus observation.Results. Sixty-nine patients, 46 having undergone inguinal and 23 ilio-inguinal lymphadenectomy, with median follow-up of 73 months were analyzed. Mean limb volume increased rapidly after surgery (7% by 3 months) and continued to increase for at least another 18 months. Patients with body mass index (BMI) >= 25 kg/m(2) had greater limb volume increase than normal-weight patients (13.3% versus 6.9%, P = 0.030). QOL improved over the first 18 months, but despite initial improvement, regional symptoms persisted long term. Type of surgery (inguinal or ilio-inguinal lymphadenectomy) had no demonstrably significant effect on limb volume (9.9% versus 13.4%, P = 0.35), QOL (P = 0.68), or regional symptoms (P = 0.65). There was no difference in overall survival between inguinal and ilio-inguinal lymphadenectomy [hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.40-1.40, P = 0.43].Conclusions. Inguinal lymphadenectomy for melanoma is a potentially morbid procedure with significant increases in limb volume. Patients report reasonable QOL but may have ongoing regional symptoms. Overweight/obesity is associated with poorer QOL, increased limb volume, and regional symptoms. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink