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Robotic-Assisted Pelvic Lymphadenectomy for Metastatic Melanoma Results in Durable Oncologic Outcomes.

机器人辅助盆腔淋巴结切除术治疗转移性黑色素瘤可获得持久的肿瘤学结果。

  • 影响因子:3.60
  • DOI:10.1245/s10434-019-07333-8
  • 作者列表:"Miura JT","Dossett LA","Thapa R","Kim Y","Potdar A","Daou H","Sun J","Sarnaik AA","Zager JS
  • 发表时间:2020-01-01
Abstract

BACKGROUND:Robotic pelvic lymphadenectomy (rPLND) has been demonstrated to be a safe and effective minimally invasive approach for patients with metastatic melanoma to the iliac nodes. However, the long-term oncologic benefit of this procedure remains poorly defined. METHODS:A single-institutional study comparing perioperative outcomes and survival [recurrence-free (RFS) and overall survival (OS)] between rPLND and open PLND (oPLND) for metastatic melanoma was conducted. RESULTS:From 2006 to 2018, a total of 63 PLND cases were identified: 22 rPLND and 41 oPLND. Evidence of isolated pelvic metastasis was the most common indication for PLND in both groups (rPLND: 64%, oPLND: 85%). There was no difference in median pelvic lymph node yield (11 vs. 9 nodes, p = 0.65). Neither treatment group experienced a Clavien-Dindo complication ≥ 3. rPLND was associated with a shorter length of stay compared with oPLND (2 vs. 4 days, p < 0.001). With a median follow-up of 37 months, there was no difference in RFS (14.4 vs. 9.6 months, p = 0.47) and OS (43 vs. 50 months, p = 0.58) between rPLND and oPLND, respectively. In basin recurrence was low with 1 (4.5%) and 3 (7.3%) patients in the rPLND and oPLND cohorts, respectively, experiencing an event (p = 0.9). CONCLUSIONS:rPLND for metastatic melanoma is a safe, minimally invasive treatment strategy that appears to result in similar intermediate term recurrence and survival rates as oPLND but shorter hospital stays.

摘要

背景: 机器人盆腔淋巴结清扫术 (rPLND) 已被证明是一种安全有效的微创方法,用于治疗髂骨转移性黑色素瘤患者。然而,该手术的长期肿瘤学益处仍不明确。 方法: 进行了一项单机构研究,比较了rPLND和开放PLND (oPLND) 治疗转移性黑色素瘤的围手术期结局和生存率 [无复发 (RFS) 和总生存率 (OS)]。 结果: 2006-2018 年,共确定了 63 例PLND病例: 22 例rPLND和 41 例oPLND。孤立性盆腔转移的证据是两组PLND最常见的适应症 (rPLND: 64%,oPLND: 85%)。中位盆腔淋巴结产量无差异 (11 vs. 9 个淋巴结,p = 0.65)。治疗组均未出现Clavien-Dindo并发症 ≥ 3。与oPLND相比,rPLND的住院时间较短 (2 vs. 4 天,p <0.001)。中位随访 37 个月,RFS无差异 (14.4 vs. 9.6 个月,p = 0.47) 和OS (43 vs。rPLND和oPLND之间分别为 50 个月,p = 0.58)。盆地复发率低,rPLND和oPLND队列中分别有 1 例 (4.5%) 和 3 例 (3) 患者发生事件 (p = 0.9)。 结论: rPLND治疗转移性黑色素瘤是一种安全、微创的治疗策略,似乎可导致与oPLND相似的中期复发率和生存率,但住院时间更短。

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影响因子:0.96
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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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