Evidence map›Paper›PMID 40674600›Full record

ArticleThe oncologist2025

Conservative lymph node surgery for patients with stage III melanoma: a prospective longitudinal cohort.

David Moreno-Ramírez, Almudena Fernández-Orland, Blanca de-Unamuno, Lucía Jiménez-Puñal, Francisco M Almazán-Fernández, Aram Boada, Juan J Ríos-Martín, Rafael Botella-Estrada, Lara Ferrándiz

Abstract readMulticenter Study
In one paragraph

Article in The oncologist, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

David Moreno-RamírezMelanoma Unit, Dermatology Department, Hospital Universitario Virgen Macarena, Seville 41009, Spain.ORCID 0000-0002-1301-7974
Almudena Fernández-OrlandMelanoma Unit, Dermatology Department, Hospital Universitario Virgen Macarena, Seville 41009, Spain.
Blanca de-UnamunoDermatology Department, Hospital Universitari i Politècnic La Fe, Valencia 46026, Spain.
Lucía Jiménez-PuñalMelanoma Unit, Dermatology Department, Hospital Universitario Virgen Macarena, Seville 41009, Spain.
Francisco M Almazán-FernándezDermatology Department, Hospital Clínico San Cecilio, Granada 18016, Spain.
Aram BoadaDermatology Department, Hospital Germans Trias i Pujol, Barcelona 08916, Spain.
Juan J Ríos-MartínPathology Department, Hospital Universitario Virgen Macarena, Seville 41009, Spain.
Rafael Botella-EstradaDermatology Department, Hospital Universitari i Politècnic La Fe, Valencia 46026, Spain.
Lara FerrándizMelanoma Unit, Dermatology Department, Hospital Universitario Virgen Macarena, Seville 41009, Spain.

Funding

European UnionMCIU-Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Health, through the project PI20/00790MCIU-Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Health, through the project PI20/01217
6 · The paper itself

Abstract

backgroundTherapeutic lymph node dissection has shown no clear benefits in terms of overall survival. However, appropriate regional control has repeatedly been reported in patients with lymph node metastasis.

objectiveThe objective of the study was to analyze the outcomes of a conservative surgical approach to patients with melanoma and lymph node metastasis detected either clinically or by imaging tests.

methodsA multicenter, prospective, longitudinal, single-arm cohort was conducted to recruit patients with melanoma who had 1-3 non-matted regional lymph node metastases (N1b, N2b) and were treated with conservative nodal surgery (conservative NS). The surgical procedure entailed resection of the metastatic lymph nodes identified, while preserving uninvolved lymph nodes in the regional basin. The patients received postoperative adjuvant immunotherapy according to routine clinical recommendations. The primary end-point was the 2-year regional lymph node recurrence-free survival (RRFS).

resultsA total of 25 patients with lymph node metastasis underwent conservative NS to remove inguinal (44.00%) and axillary (56.00%) lymph node metastasis. During the follow-up, 36.00% (n = 9) of the patients developed recurrence in the regional basin treated with conservative NS. The 2-year RRFS was 65.70% (95% CI 46.30%-85.10%), and MSS was 78.10% (95% CI 60.85%-95.35%) at 2 years. Stage IIIB patients exhibited no statistically significant improvement in 2-year RRFS (83.30%) (log-rank P = .238). The short-term surgical complications reported were seroma (32%, n = 8), hematoma (8%, n = 2), and wound infection (4%, n = 1). No cases of lymphedema were observed.

conclusionConservative NS has the potential to prevent unnecessary complete lymph node dissections, particularly in clinical settings where neoadjuvant immunotherapy is not a suitable first-line therapeutic option.

Indexed as

Lymph Node ExcisionLymph NodesMelanomaSkin NeoplasmsAdultAgedFemaleHumansLongitudinal StudiesLymphatic MetastasisMaleMiddle AgedNeoplasm StagingProspective Studiescutaneous melanomalymph node dissectionlymph node metastasisoncologic surgeryrecurrence-free survivalstage III melanoma

Identifiers

PMID40674600
PMCPMC12449619

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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.