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Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis

The aim of this meta-analysis was to answer the question as to whether performing CLND (complete lymph node dissection) is necessary in every case of the melanoma patient after the positive SNB (sentinel node biopsy). To resolve doubts the authors reanalyzed previous articles and systematized the kn...

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Autores principales: Richter, Karolina, Stefura, Tomasz, Macheta, Krzysztof, Tempski, Jonasz, Kazoń, Jakub, Szeremeta, Magdalena, Klimont, Paweł, Kołodziej-Rzepa, Marta, Wojewoda, Tomasz, Wysocki, Wojciech M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267433/
https://www.ncbi.nlm.nih.gov/pubmed/35807174
http://dx.doi.org/10.3390/jcm11133880
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author Richter, Karolina
Stefura, Tomasz
Macheta, Krzysztof
Tempski, Jonasz
Kazoń, Jakub
Szeremeta, Magdalena
Klimont, Paweł
Kołodziej-Rzepa, Marta
Wojewoda, Tomasz
Wysocki, Wojciech M.
author_facet Richter, Karolina
Stefura, Tomasz
Macheta, Krzysztof
Tempski, Jonasz
Kazoń, Jakub
Szeremeta, Magdalena
Klimont, Paweł
Kołodziej-Rzepa, Marta
Wojewoda, Tomasz
Wysocki, Wojciech M.
author_sort Richter, Karolina
collection PubMed
description The aim of this meta-analysis was to answer the question as to whether performing CLND (complete lymph node dissection) is necessary in every case of the melanoma patient after the positive SNB (sentinel node biopsy). To resolve doubts the authors reanalyzed previous articles and systematized the knowledge about the concerning medical problem. The databases such as PubMed, Scopus and Web of Science were screened to find articles that will be helpful to answer the controversial question if performing lymphadenectomy is crucial. The inclusion criteria consisted of randomized clinical trials, comparison of lymphadenectomy versus observation and positive sentinel node biopsy. After which, seven articles were examined. Authors analyzed parameters such as: recurrence, 3-year survival and 5-year survival. There was no relationship between the performance of CLND and melanoma recurrence (OR 1.04; 95% CI: 0.82–1.31; p = 0.75). However, no CLND group had higher 3-year survival (OR 1.22; 95% CI: 1.03–1.44; p = 0.02) and 5-year survival (OR 1.30; 95% CI: 1.19–1.85; p = 0.008). In conclusion, the observational approach to the melanoma patients with positive sentinel node biopsy is associated with comparable or slightly improved 3- and 5-year survival, then in case of routine lymphadenectomy. Although, in each melanoma patient a decision to perform or withhold lymphadenectomy should always be considered individually. Patients with low perioperative risk could be considered for surgical approach. The study was registered in PROSPERO and was assigned with the unique identifying number “CRD42021241272”.
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spelling pubmed-92674332022-07-09 Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis Richter, Karolina Stefura, Tomasz Macheta, Krzysztof Tempski, Jonasz Kazoń, Jakub Szeremeta, Magdalena Klimont, Paweł Kołodziej-Rzepa, Marta Wojewoda, Tomasz Wysocki, Wojciech M. J Clin Med Review The aim of this meta-analysis was to answer the question as to whether performing CLND (complete lymph node dissection) is necessary in every case of the melanoma patient after the positive SNB (sentinel node biopsy). To resolve doubts the authors reanalyzed previous articles and systematized the knowledge about the concerning medical problem. The databases such as PubMed, Scopus and Web of Science were screened to find articles that will be helpful to answer the controversial question if performing lymphadenectomy is crucial. The inclusion criteria consisted of randomized clinical trials, comparison of lymphadenectomy versus observation and positive sentinel node biopsy. After which, seven articles were examined. Authors analyzed parameters such as: recurrence, 3-year survival and 5-year survival. There was no relationship between the performance of CLND and melanoma recurrence (OR 1.04; 95% CI: 0.82–1.31; p = 0.75). However, no CLND group had higher 3-year survival (OR 1.22; 95% CI: 1.03–1.44; p = 0.02) and 5-year survival (OR 1.30; 95% CI: 1.19–1.85; p = 0.008). In conclusion, the observational approach to the melanoma patients with positive sentinel node biopsy is associated with comparable or slightly improved 3- and 5-year survival, then in case of routine lymphadenectomy. Although, in each melanoma patient a decision to perform or withhold lymphadenectomy should always be considered individually. Patients with low perioperative risk could be considered for surgical approach. The study was registered in PROSPERO and was assigned with the unique identifying number “CRD42021241272”. MDPI 2022-07-04 /pmc/articles/PMC9267433/ /pubmed/35807174 http://dx.doi.org/10.3390/jcm11133880 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Richter, Karolina
Stefura, Tomasz
Macheta, Krzysztof
Tempski, Jonasz
Kazoń, Jakub
Szeremeta, Magdalena
Klimont, Paweł
Kołodziej-Rzepa, Marta
Wojewoda, Tomasz
Wysocki, Wojciech M.
Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis
title Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis
title_full Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis
title_fullStr Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis
title_full_unstemmed Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis
title_short Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis
title_sort does it really pay-off? comparison of lymphadenectomy versus observational approach in skin melanoma with positive sentinel node biopsy: systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267433/
https://www.ncbi.nlm.nih.gov/pubmed/35807174
http://dx.doi.org/10.3390/jcm11133880
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