caa a22 4500 445334657 CHVBK 20180317142750.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1750-z doi (NATIONALLICENCE)springer-10.1245/s10434-011-1750-z Inguinopelvic Lymphadenectomy Following Positive Inguinal Sentinel Lymph Node Biopsy in Melanoma: True Frequency of Synchronous Pelvic Metastases [Elektronische Daten] [Carrie Chu, Keith Delman, Grant Carlson, Andrea Hestley, Douglas Murray] Background: True frequency of synchronous pelvic metastases with positive inguinal sentinel lymph node (SLN) biopsy is unknown. Role of pelvic dissection in the SLN era is unclear. Methods: From 1994 to 2004, 1 surgeon routinely performed nonselective, complete inguinopelvic lymphadenectomy after positive inguinal SLN biopsy. All cases were identified from a prospectively maintained database. Clinicopathologic features associated with pelvic disease were assessed. Results: A total of 40 patients with positive inguinal SLN underwent, without additional selection, 42 complete inguinopelvic lymphadenectomies. Median age was 46.5years (range 25-79years); 79% had lower extremity primaries. Median Breslow depth was 2.3mm (range 1.0-10.0mm), Clark's IV/V 98%, ulceration 26%. Frequency of synchronous pelvic disease upon completion lymphadenectomy was 5 of 42 (11.9%). Patients with and without pelvic disease were similar in age, sex, Breslow depth, Clark's level, ulceration, and mitoses. All 5 cases with pelvic metastases had extremity primaries (4 distal, 1 proximal). Of the 5, 3 (60%) had ≥3 total involved inguinal nodes, compared with only 1 (2.7%) of the 37 cases without pelvic disease (P=.003). Ratio of positive to total number inguinal nodes retrieved was >0.20 in 80% of cases with pelvic disease and 8.6% of cases without (P=.002). Upon lymphoscintigraphy review, secondary pelvic drainage was present in 80% of cases with pelvic disease compared with 56% of cases without pelvic disease, though the trend was statistically insignificant (P=.63). Conclusions: In this cohort of unselected, SLN-positive patients with complete inguinopelvic lymphadenectomy, frequency of synchronous pelvic disease was 11.9%. Patients with ≥3 total involved inguinal nodes or inguinal node ratio >0.20 appear more likely to harbor pelvic disease. Society of Surgical Oncology, 2011 Chu Carrie Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut Delman Keith Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut Carlson Grant Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut Hestley Andrea Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut Murray Douglas Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3309-3315 1068-9265 18:12<3309 2011 18 10434 https://doi.org/10.1245/s10434-011-1750-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1750-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chu Carrie Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Delman Keith Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Carlson Grant Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Hestley Andrea Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Murray Douglas Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, GA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3309-3315 1068-9265 18:12<3309 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer