Lymph node dissections in cutaneous malignancy: Where are we now? A review of 10 years' experience at a tertiary centre.
In: Journal of Plastic, Reconstructive & Aesthetic Surgery, Jg. 74 (2021-11-01), Heft 11, S. 2993-2998
academicJournal
Zugriff:
The surgical management of cutaneous malignancies has evolved over recent years with the introduction of novel medical therapies and an increasing emphasis upon early adjuvant systemic therapy. As such, completion lymph node dissection (cLND) is now no longer recommended following a positive sentinel lymph node biopsy (SLNB) in melanoma. We evaluated our ten-year practice at a regional tertiary centre, assessing the change in lymph node dissection (LND) caseload volume, anatomical distribution, and indication for the procedure. A retrospective search was carried out of all LNDs performed by the Plastic Surgery department at Cambridge University Hospitals NHS Trust, UK from 1 January 2010 to 31 December 2019. Case notes were retrospectively analysed for each procedure, with the site and pathology recorded. A total of 491 LNDs were performed over the 10-year period. Surgical volume peaked in 2015 with 67 cases, followed by a decline to 41 cases in 2019. The number of neck dissections increased over the decade, as well as the proportion of cases due to macroscopic nodal disease. We sub-analysed the number of LNDs in three contiguous 18-month intervals, corresponding to changes in practice due to evidence from the DeCOG and MSLT-II Trials. We found a 41.67% reduction in LNDs caseload between July 2018-Dec 2019, compared to a similar period prior to trial evidence (July 2015-Dec 2016) (p=0.0.14). In summary, the surgical volume of LNDs has decreased significantly since 2018, reflecting emerging evidence and changes to national guidelines. This will require ongoing monitoring for workforce planning and surgical training. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Plastic, Reconstructive & Aesthetic Surgery is the property of Churchill Livingstone, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Lymph node dissections in cutaneous malignancy: Where are we now? A review of 10 years' experience at a tertiary centre.
|
---|---|
Autor/in / Beteiligte Person: | Jones, Oliver ; Murphy, Suzanne H ; Biosse-Duplan, Garance ; Patel, Animesh J K ; Roshan, Amit ; Durrani, Amer J |
Zeitschrift: | Journal of Plastic, Reconstructive & Aesthetic Surgery, Jg. 74 (2021-11-01), Heft 11, S. 2993-2998 |
Veröffentlichung: | 2021 |
Medientyp: | academicJournal |
ISSN: | 1748-6815 (print) |
DOI: | 10.1016/j.bjps.2021.03.115 |
Sonstiges: |
|