AI Article Synopsis
- The meta-analysis aimed to compare survival rates after immediate complete lymph node dissection (CLND) versus observation only (OO) or delayed CLND in melanoma patients with lymph node metastasis.
- Four randomized controlled trials were analyzed, showing no significant difference in melanoma-specific survival (MSS) between CLND and OO, but indicated that immediate CLND might improve survival compared to delayed CLND in certain patients.
- The findings suggest that while CLND may not enhance survival compared to observation, early surgical intervention could offer better long-term outcomes for patients with nodal metastasis.
Article Abstract
Background: The aim of this meta-analysis was to estimate the survival after immediate complete lymph node dissection (CLND) compared to observation only (OO) or delayed CLND in patients with melanoma and lymph node metastasis.
Materials And Methods: A systematic search was performed in: PubMed, Web of Science, Cochrane Library, CINAHL, Clinical trials and Embase. Eligible studies were randomized controlled trials (RCTs) comparing: CLND with OO, or immediate CLND with delayed CLND.
Results: Four RCTs were included. There was no difference in melanoma-specific survival (MSS) (HR=0.91, 95% CI=0.77-1.08, p=0.29). In a sensitivity analysis, MSS was higher after immediate CLND compared to delayed CLND in patients with nodal metastasis (HR=0.63, 95% CI=0.35-0.74, p=0.0004) without evidence of heterogeneity.
Conclusion: CLND appears to have no additional survival benefit after SNB compared to OO. However, subgroup analysis suggests a time-dependent benefit for early surgical lymph node removal compared to delayed or none.
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| http://dx.doi.org/10.21873/anticanres.12143 | DOI Listing |
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