Cover Image

Complete lymph node dissection versus selective lymph node extirpation in melanoma patients with nodal macrometastasis and adjuvant systemic therapy

Background and Objectives Complete lymph node dissection (CLND) is the standard of care in patients with regional nodal melanoma macrometastasis. However, evidence on surgical procedures in the era of adjuvant systemic therapies is lacking. Patients and Methods This retrospective multi-center study...

Full description

Saved in:
Bibliographic Details
Main Authors: Mayer, Kristine E. (Author) , Hassel, Jessica C. (Author) , Sambale, Jannik (Author) , Erdmann, Michael (Author) , Sindrilaru, Mihaela-Anca (Author) , Oberschmied, Julia (Author) , Thiem, Alexander (Author) , Tomsitz, Dirk (Author) , Knuever, Jana (Author) , Schlaak, Max (Author) , Berking, Carola (Author) , Posch, Christian (Author) , Biedermann, Tilo (Author) , Persa, Oana-Diana (Author)
Format: Article (Journal)
Language:English
Published: 2026
Edition:Early view
In: Journal der Deutschen Dermatologischen Gesellschaft
Year: 2026, Pages: 1-10
ISSN:1610-0387
DOI:10.1111/ddg.15967
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1111/ddg.15967
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/ddg.15967
Get full text
Author Notes:Kristine E. Mayer, Jessica C. Hassel, Jannik Sambale, Michael Erdmann, Mihaela-Anca Sindrilaru, Julia Oberschmied, Alexander Thiem, Dirk Tomsitz, Jana Knuever, Max Schlaak, Carola Berking, Christian Posch, Tilo Biedermann, Oana-Diana Persa
Description
Summary:Background and Objectives Complete lymph node dissection (CLND) is the standard of care in patients with regional nodal melanoma macrometastasis. However, evidence on surgical procedures in the era of adjuvant systemic therapies is lacking. Patients and Methods This retrospective multi-center study included stage IIIB-D melanoma patients with nodal macrometastasis undergoing CLND or selective lymph node extirpation (LNE) prior to adjuvant therapy. CLND and LNE were compared regarding recurrence-free survival (RFS), nodal metastasis-free survival (NFS) and overall survival (OS). Results 320 melanoma patients were included (median age 62; 55.5% male). Patients received PD-1 monotherapy (77.8%), targeted therapy (21.3%) or both sequentially (0.9%), as well as adjuvant radiotherapy in 40.9%. RFS and OS did not differ significantly between patients receiving CLND or LNE, while NFS was significantly prolonged following CLND (HR 0.3917; p = 0.005). After adjustment for risk factors by multivariate Cox regression, a prolonged RFS for CLND vs. LNE was found (HR 0.676; p = 0.04), but no benefit for OS. The rate of complications was significantly higher in the CLND group. Conclusions CLND showed no OS benefit compared to LNE, while local control was improved. CLND can be recommended in the context of adjuvant therapies, however, the increased rate of complications should be considered.
Item Description:Gesehen am 25.03.2026
Physical Description:Online Resource
ISSN:1610-0387
DOI:10.1111/ddg.15967

Similar Items