Is there a relation between type of primary melanoma treatment and the development of intralymphatic metastasis? A review of the literature

S. Sloot; M. J. Speijers; E. Bastiaannet; H. J. Hoekstra

doi:10.1016/j.ctrv.2016.02.007

Is there a relation between type of primary melanoma treatment and the development of intralymphatic metastasis? A review of the literature

S. Sloot, M. J. Speijers, E. Bastiaannet, H. J. Hoekstra^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Intralymphatic metastases (ILM) originate from tumor cell emboli entrapped in dermal lymphatics between primary tumor and regional lymph node basin. Because of this origin, sentinel lymph node biopsy (SLNB) might increase ILM by restricting lymph flow.

Methods: Pubmed, Embase, Cochrane and Medline were searched for articles on ILM between 1980 and September 2014. ILM Incidences were calculated after wide local excision (WLE), excision with elective lymph node dissection (ELND) or therapeutic lymph node dissection (TLND), WLE with SLNB with or without completion lymph node dissection (CLND) and delayed lymph node dissection (DLND) for patients developing nodal metastasis during follow-up.

Results: In 36 studies, 14,729 patients underwent WLE, 1682 patients WLE/ELND, 362 patients WLE/DLND and 11,201 patients WLE/SLNB. On meta-analysis, ILM occurrence was 3.4% (95% CI 2.8-4.2%). ILM occurred most frequently in the WLE/DLND group (5.5%, 95% CI 3.5-8.7%), followed by WLE/ELND (4.7%, 95% CI 3.1-7.0%), WLE/SLNB (4.5%, 95% CI 3.5-5.7%) and WLE alone (1.9%, 95% CI 1.4-2.7%). 1330 SLNB+ patients were identified and 5783 SLNB patients. For these groups, on meta-analysis, ILM recurrence was 13.2% (95% CI 10.8-16.2%) and 3.4% (95% CI 2.5-4.5%), respectively (p = 0.01).

Conclusion: In this review SLNB is associated with an increase of ILM with an incidence of 1.9% for WLE vs. 3.4% for SNLB. Selection bias in this review cannot be excluded. However, ILM occur four times more frequently after SLNB+ than SLNB procedures and more often after SLNB+/CLND than WLE/DLND or WLE/ELND. ILM should therefore be viewed as a bio-marker of aggressive primary disease.

Synopsis: Sentinel lymph node biopsy is thought to increase intralymphatic metastasis by restricting lymph flow. This review demonstrates that there is an increase in metastasis, but this result has to be interpreted with caution due to possible selection bias. Aggressive tumor characteristics are likely the cause of this increase. (C) 2016 The Authors. Published by Elsevier Ltd.

Original language	English
Pages (from-to)	120-128
Number of pages	9
Journal	CANCER TREATMENT REVIEWS
Volume	45
DOIs	https://doi.org/10.1016/j.ctrv.2016.02.007
Publication status	Published - Apr-2016
Event	10th International Melanoma Congress of the Society-for-Melanoma-Research (SMR) - Philadelphia, Panama Duration: 17-Nov-2013 → 20-Nov-2013

Keywords

Melanoma
Sentinel lymph node biopsy
Lymph node excision
Surgery
Neoplasm metastasis
Recurrence
Review
SENTINEL LYMPH-NODE
CUTANEOUS MALIGNANT-MELANOMA
IN-TRANSIT METASTASES
FOLLOW-UP
INGUINAL LYMPHADENECTOMY
RECURRENCE PATTERNS
LOCAL RECURRENCE
1ST RECURRENCE
BIOPSY
DISSECTION

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@article{b4ed5012d9fe40cdb4a4197f7a386739,

title = "Is there a relation between type of primary melanoma treatment and the development of intralymphatic metastasis? A review of the literature",

abstract = "Background: Intralymphatic metastases (ILM) originate from tumor cell emboli entrapped in dermal lymphatics between primary tumor and regional lymph node basin. Because of this origin, sentinel lymph node biopsy (SLNB) might increase ILM by restricting lymph flow.Methods: Pubmed, Embase, Cochrane and Medline were searched for articles on ILM between 1980 and September 2014. ILM Incidences were calculated after wide local excision (WLE), excision with elective lymph node dissection (ELND) or therapeutic lymph node dissection (TLND), WLE with SLNB with or without completion lymph node dissection (CLND) and delayed lymph node dissection (DLND) for patients developing nodal metastasis during follow-up.Results: In 36 studies, 14,729 patients underwent WLE, 1682 patients WLE/ELND, 362 patients WLE/DLND and 11,201 patients WLE/SLNB. On meta-analysis, ILM occurrence was 3.4% (95% CI 2.8-4.2%). ILM occurred most frequently in the WLE/DLND group (5.5%, 95% CI 3.5-8.7%), followed by WLE/ELND (4.7%, 95% CI 3.1-7.0%), WLE/SLNB (4.5%, 95% CI 3.5-5.7%) and WLE alone (1.9%, 95% CI 1.4-2.7%). 1330 SLNB+ patients were identified and 5783 SLNB patients. For these groups, on meta-analysis, ILM recurrence was 13.2% (95% CI 10.8-16.2%) and 3.4% (95% CI 2.5-4.5%), respectively (p = 0.01).Conclusion: In this review SLNB is associated with an increase of ILM with an incidence of 1.9% for WLE vs. 3.4% for SNLB. Selection bias in this review cannot be excluded. However, ILM occur four times more frequently after SLNB+ than SLNB procedures and more often after SLNB+/CLND than WLE/DLND or WLE/ELND. ILM should therefore be viewed as a bio-marker of aggressive primary disease.Synopsis: Sentinel lymph node biopsy is thought to increase intralymphatic metastasis by restricting lymph flow. This review demonstrates that there is an increase in metastasis, but this result has to be interpreted with caution due to possible selection bias. Aggressive tumor characteristics are likely the cause of this increase. (C) 2016 The Authors. Published by Elsevier Ltd.",

keywords = "Melanoma, Sentinel lymph node biopsy, Lymph node excision, Surgery, Neoplasm metastasis, Recurrence, Review, SENTINEL LYMPH-NODE, CUTANEOUS MALIGNANT-MELANOMA, IN-TRANSIT METASTASES, FOLLOW-UP, INGUINAL LYMPHADENECTOMY, RECURRENCE PATTERNS, LOCAL RECURRENCE, 1ST RECURRENCE, BIOPSY, DISSECTION",

author = "S. Sloot and Speijers, {M. J.} and E. Bastiaannet and Hoekstra, {H. J.}",

year = "2016",

month = apr,

doi = "10.1016/j.ctrv.2016.02.007",

language = "English",

volume = "45",

pages = "120--128",

journal = "CANCER TREATMENT REVIEWS",

issn = "0305-7372",

publisher = "ELSEVIER SCI LTD",

note = "10th International Melanoma Congress of the Society-for-Melanoma-Research (SMR) ; Conference date: 17-11-2013 Through 20-11-2013",

}

TY - JOUR

T1 - Is there a relation between type of primary melanoma treatment and the development of intralymphatic metastasis? A review of the literature

AU - Sloot, S.

AU - Speijers, M. J.

AU - Bastiaannet, E.

AU - Hoekstra, H. J.

PY - 2016/4

Y1 - 2016/4

N2 - Background: Intralymphatic metastases (ILM) originate from tumor cell emboli entrapped in dermal lymphatics between primary tumor and regional lymph node basin. Because of this origin, sentinel lymph node biopsy (SLNB) might increase ILM by restricting lymph flow.Methods: Pubmed, Embase, Cochrane and Medline were searched for articles on ILM between 1980 and September 2014. ILM Incidences were calculated after wide local excision (WLE), excision with elective lymph node dissection (ELND) or therapeutic lymph node dissection (TLND), WLE with SLNB with or without completion lymph node dissection (CLND) and delayed lymph node dissection (DLND) for patients developing nodal metastasis during follow-up.Results: In 36 studies, 14,729 patients underwent WLE, 1682 patients WLE/ELND, 362 patients WLE/DLND and 11,201 patients WLE/SLNB. On meta-analysis, ILM occurrence was 3.4% (95% CI 2.8-4.2%). ILM occurred most frequently in the WLE/DLND group (5.5%, 95% CI 3.5-8.7%), followed by WLE/ELND (4.7%, 95% CI 3.1-7.0%), WLE/SLNB (4.5%, 95% CI 3.5-5.7%) and WLE alone (1.9%, 95% CI 1.4-2.7%). 1330 SLNB+ patients were identified and 5783 SLNB patients. For these groups, on meta-analysis, ILM recurrence was 13.2% (95% CI 10.8-16.2%) and 3.4% (95% CI 2.5-4.5%), respectively (p = 0.01).Conclusion: In this review SLNB is associated with an increase of ILM with an incidence of 1.9% for WLE vs. 3.4% for SNLB. Selection bias in this review cannot be excluded. However, ILM occur four times more frequently after SLNB+ than SLNB procedures and more often after SLNB+/CLND than WLE/DLND or WLE/ELND. ILM should therefore be viewed as a bio-marker of aggressive primary disease.Synopsis: Sentinel lymph node biopsy is thought to increase intralymphatic metastasis by restricting lymph flow. This review demonstrates that there is an increase in metastasis, but this result has to be interpreted with caution due to possible selection bias. Aggressive tumor characteristics are likely the cause of this increase. (C) 2016 The Authors. Published by Elsevier Ltd.

AB - Background: Intralymphatic metastases (ILM) originate from tumor cell emboli entrapped in dermal lymphatics between primary tumor and regional lymph node basin. Because of this origin, sentinel lymph node biopsy (SLNB) might increase ILM by restricting lymph flow.Methods: Pubmed, Embase, Cochrane and Medline were searched for articles on ILM between 1980 and September 2014. ILM Incidences were calculated after wide local excision (WLE), excision with elective lymph node dissection (ELND) or therapeutic lymph node dissection (TLND), WLE with SLNB with or without completion lymph node dissection (CLND) and delayed lymph node dissection (DLND) for patients developing nodal metastasis during follow-up.Results: In 36 studies, 14,729 patients underwent WLE, 1682 patients WLE/ELND, 362 patients WLE/DLND and 11,201 patients WLE/SLNB. On meta-analysis, ILM occurrence was 3.4% (95% CI 2.8-4.2%). ILM occurred most frequently in the WLE/DLND group (5.5%, 95% CI 3.5-8.7%), followed by WLE/ELND (4.7%, 95% CI 3.1-7.0%), WLE/SLNB (4.5%, 95% CI 3.5-5.7%) and WLE alone (1.9%, 95% CI 1.4-2.7%). 1330 SLNB+ patients were identified and 5783 SLNB patients. For these groups, on meta-analysis, ILM recurrence was 13.2% (95% CI 10.8-16.2%) and 3.4% (95% CI 2.5-4.5%), respectively (p = 0.01).Conclusion: In this review SLNB is associated with an increase of ILM with an incidence of 1.9% for WLE vs. 3.4% for SNLB. Selection bias in this review cannot be excluded. However, ILM occur four times more frequently after SLNB+ than SLNB procedures and more often after SLNB+/CLND than WLE/DLND or WLE/ELND. ILM should therefore be viewed as a bio-marker of aggressive primary disease.Synopsis: Sentinel lymph node biopsy is thought to increase intralymphatic metastasis by restricting lymph flow. This review demonstrates that there is an increase in metastasis, but this result has to be interpreted with caution due to possible selection bias. Aggressive tumor characteristics are likely the cause of this increase. (C) 2016 The Authors. Published by Elsevier Ltd.

KW - Melanoma

KW - Sentinel lymph node biopsy

KW - Lymph node excision

KW - Surgery

KW - Neoplasm metastasis

KW - Recurrence

KW - Review

KW - SENTINEL LYMPH-NODE

KW - CUTANEOUS MALIGNANT-MELANOMA

KW - IN-TRANSIT METASTASES

KW - FOLLOW-UP

KW - INGUINAL LYMPHADENECTOMY

KW - RECURRENCE PATTERNS

KW - LOCAL RECURRENCE

KW - 1ST RECURRENCE

KW - BIOPSY

KW - DISSECTION

U2 - 10.1016/j.ctrv.2016.02.007

DO - 10.1016/j.ctrv.2016.02.007

M3 - Article

SN - 0305-7372

VL - 45

SP - 120

EP - 128

JO - CANCER TREATMENT REVIEWS

JF - CANCER TREATMENT REVIEWS

T2 - 10th International Melanoma Congress of the Society-for-Melanoma-Research (SMR)

Y2 - 17 November 2013 through 20 November 2013

ER -

Is there a relation between type of primary melanoma treatment and the development of intralymphatic metastasis? A review of the literature

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Keywords

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