caa a22 4500 445338555 CHVBK 20180317142804.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1801-5 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1801-5 Outcome After Therapeutic Lymph Node Dissection in Patients with Unknown Primary Melanoma Site [Elektronische Daten] [Sebastiaan Prens, Augustinus van der Ploeg, Alexander van Akkooi, Cornelis van Montfort, Albertus van Geel, Johannes de Wilt, Alexander Eggermont, Cornelis Verhoef] Purpose: The aim of this study was to evaluate the incidence and outcome of melanoma of unknown primary site (MUP) after therapeutic lymph node dissection (TLND) of palpable nodal melanoma metastases. Disease-free (DFS) and overall survival (OS) time of MUP patients were analyzed and compared to patients undergoing a TLND for known primary melanomas (MKP). Methods: This single institution retrospective study analyzed 342 consecutive patients who were treated with 415 TLNDs for palpable nodal disease from 1982 to 2009. Univariate and multivariate analyses included: MUP versus MKP, gender, Breslow thickness, ulceration of primary tumor, site of primary tumor, site of dissection, extracapsular extension, number of collected nodes, number of positive nodes and the node positive ratio. Results: A total of 47 MUP were identified in 342 patients (13.7%). In univariate analysis, a trend was seen toward better survival for MUP patients compared to MKP patients having 5-year OS rates of 40% and 27%, respectively (P=0.06). Multivariate analysis for OS showed two highly significant factors associated with worse prognosis: extracapsular extension and N3 status (both P<0.001). Two factors were associated with a significant better prognosis: MUP (P=0.03) and a neck dissection (P=0.04). Conclusions: Patients with MUP showed a statistically significant better OS compared to patients with melanoma metastases from known primary tumors. Presence of extracapsular extension and an increased number of positive nodes are statistically significantly negative prognostic factors for OS. The absence of a primary melanoma in stage III melanoma patients does not preclude surgery. The Author(s), 2011 Prens Sebastiaan Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut van der Ploeg Augustinus Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut van Akkooi Alexander Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut van Montfort Cornelis Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut van Geel Albertus Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut de Wilt Johannes Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands aut Eggermont Alexander Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut Verhoef Cornelis Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3586-3592 1068-9265 18:13<3586 2011 18 10434 https://doi.org/10.1245/s10434-011-1801-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1801-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Prens Sebastiaan Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van der Ploeg Augustinus Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Akkooi Alexander Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Montfort Cornelis Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Geel Albertus Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- de Wilt Johannes Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Eggermont Alexander Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Verhoef Cornelis Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3586-3592 1068-9265 18:13<3586 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer