Information de reference pour ce titreAccession Number: | 01445386-200906010-00017.
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Author: | Xing, Yan MD, MS PhD 1; Badgwell, Brian D. MD 1; Ross, Merrick I. MD 1; Gershenwald, Jeffrey E. MD 1; Lee, Jeffrey E. MD 1; Mansfield, Paul F. MD 1; Lucci, Anthony MD 1; Cormier, Janice N. MD, MPH 1*
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Institution: | (1) Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (*)Corresponding author: Department of Surgical Oncology, Unit 444, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-4009
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Title: | |
Source: | Cancer. 115(11):2505-2513, June 1, 2009.
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Abstract: | BACKGROUND: The objectives of this analysis were to compare various measures associated with lymph node (LN) dissection and to identify threshold values associated with disease-specific survival (DSS) outcomes in patients with melanoma.
METHODS: Patients with lymph node-positive melanoma who underwent therapeutic LN dissection of the neck, axilla, and inguinal region were identified from the SEER database (1988-2005). We performed Cox multivariate analyses to determine the impact of the total number of LNs removed, number of negative LNs removed, and LN ratio on DSS. Multivariate cut-point analyses were conducted for each anatomic region to identify the threshold values associated with the largest improvement in DSS.
RESULTS: The LN ratio was significantly associated with DSS for all LN regions. The LN ratio thresholds resulting in the greatest difference in 5-year DSS were .07, .13, and .18 for neck, axillary, and inguinal regions, respectively, corresponding to 15, 8, and 6 LNs removed per positive lymph node. After adjustment for other clinicopathologic factors, the hazard ratios (HRs) were .53 (95% confidence interval [CI], .40 to .71) in the neck, .52 (95% CI, .42 to .65) in the axillary, and .47 (95% CI, .36 to .61) in the inguinal regions for patients who met the LN ratio threshold.
CONCLUSIONS: Among the prognostic factors examined, LN ratio was the best indicator of the extent of LN dissection, regardless of anatomic nodal region. These data provide evidence-based guidelines for defining adequate LN dissections in melanoma patients.
Various measures associated with lymph node (LN) dissection were examined to identify threshold values associated with disease-specific survival in patients with melanoma. LN ratio was the best indicator of the extent of LN dissection, and a total of 15, 8, and 6 LNs removed per positive lymph node in the neck, axillary, and inguinal region resulted in the greatest differences in DSS.
Copyright (C) 2009 John Wiley & Sons, Inc.
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Author Keywords: | melanoma; lymphadenectomy; lymph node ratio; disease-specific survival.
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Language: | English.
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Document Type: | Original Article.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0008-543X
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DOI Number: | https://dx.doi.org/10.1002/cncr....- ouverture dans une nouvelle fenêtre
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