Evidence map›Paper›PMID 38762644›Full record

ArticleAnnals of surgical oncology2024

The Effect of Neoadjuvant Systemic Therapy on Surgical Outcomes After Lymph Node Dissections for Stage III Melanoma; An Australian Cohort.

Lisanne P Zijlker, Henry Chen, Andrew J Spillane, Maria Gonzalez, Thomas E Pennington, Alexander M Menzies, Serigne N Lo, Peter Ferguson, Robert Rawson, Andrew J Colebatch and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Lisanne P ZijlkerNetherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands.
Henry ChenFaculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Andrew J SpillaneMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Maria GonzalezMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Thomas E PenningtonMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Alexander M MenziesMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Serigne N LoMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Peter FergusonMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Robert RawsonMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Andrew J ColebatchMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Jonathan R StretchMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
John F ThompsonMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Sydney Ch'ngMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Omgo NiewegMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Kerwin F ShannonMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Georgina V LongMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Richard A ScolyerMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Robyn P M SawMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Alexander C J van AkkooiMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. alexander.vanakkooi@melanoma.org.au.

Funding

National Health and Medical Research Council 2022/GNT2018514
6 · The paper itself

Abstract

backgroundNeoadjuvant systemic therapy (NAST) for patients with stage III melanoma achieves high major pathologic response rates and high recurrence-free survival rates. This study aimed to determine how NAST with targeted therapies (TTs) and immune checkpoint inhibitors (ICIs) influences surgical outcomes after lymph node dissection in terms of complications, morbidity, and textbook outcomes.

methodsPatients who underwent a lymph node dissection after either NAST in a clinical trial or upfront surgery for stage III melanoma between 2014 and 2022 were identified from an institutional research database.

resultsThe study included 89 NAST-treated patients and 79 upfront surgery-treated patients. The rate of postoperative complications did not differ between the NAST- and upfront surgery-treated patients (55% vs. 51%; p = 0.643), and steroid treatment for drug toxicity did not influence the complication rate (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.4-3; p = 0.826). No significant differences in postoperative morbidity were observed in terms of seroma (23% vs. 11%; p = 0.570) or lymphedema (36% vs. 51%; p = 0.550). The rate of achieving a textbook outcome was comparable for the two groups (61% vs. 57%; p = 0.641).

conclusionsThe surgical outcomes after lymph node dissections were comparable between the patients who received NAST and those who had upfront surgery, indicating that surgery can be safely performed after NAST with TT or ICI for stage III melanoma.

Indexed as

Lymph Node ExcisionMelanomaNeoadjuvant TherapyNeoplasm StagingAdultAgedAntineoplastic Combined Chemotherapy ProtocolsAustraliaFemaleFollow-Up StudiesHumansImmune Checkpoint InhibitorsMaleMiddle AgedPostoperative ComplicationsPrognosisImmune Checkpoint InhibitorsComplicationsMelanomaNeoadjuvantSurgerySystemic therapyTextbook outcomes

Identifiers

PMID38762644
PMCPMC11236868

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.