TY  - THES
A1  - Mathe, Katrin
T1  - Bedeutung der erweiterten Lymphadenektomie in Bezug auf die Morbidität und das lokalrezidivfreie Überleben bei Patienten mit malignem Melanom
T1  - Impact of extended Lymphadenectomy on Morbidity and Recurrence-free Survival in Melanoma Patients
N2  - An 245 Patienten erfolgte eine retrospektive Sudie Bezug nehmend auf die Morbidität und das lokalrezidivfreie Überleben bei Patienten mit malignem Melanom, die entweder eine limitierte oder eine erweiterte axilläre oder inguinale Lymphadenektomie erhielten. 
Nach Wissen der Autoren ist vorliegende Studie die erste ihrer Art, die aufzeigt, dass die Durchführung einer erweiterten Lymphadenektomie zu keiner erhöhten Morbidität führt.
Bei Patienten mit einem positiven Lymphknotenstatus verbessert die erweiterte Lymphadenektomie das lokalrezidivfreie Überleben. 
Daher stellt die erweiterte Lymphadenektomie ein mögliches Qualitätsmerkmal der axillären und inguinalen Lymphadenektomie in der Therapie des malignen Melanoms dar.
N2  - Background: Although the number of excised lymph nodes during lymph node dissection (LND) is an independent predictor of melanoma-specific survival in melanoma patients, current guidelines do not set a concrete cut-off limit for the number of lymph nodes to be resected during LND. Here we investigate if extended LND (ext-LND) has an impact on surgical morbidity and oncological outcome in melanoma patients.
Methods: As many as 245 melanoma patients receiving axillary or inguinal LND in curative intention were investigated retrospectively. Ext-LND was defined as axillary LND with 20 or more resected lymph nodes and inguinal LND with 10 or more resected lymph nodes. Surgical morbidity (lymphatic fistulas, wound infections, severe bleeding, neurological affection) and local recurrence-free survival were also investigated.
Results: Ext-LND did not lead to increased surgical morbidity in the overall study collective. After ext-LND, 55.4% of the patients experienced one of the investigated complications compared to 46.2% in the limited LND group (p=0.2113). There was no difference in the occurrence of lymphatic fistula, wound infection, severe bleeding, or neurological affection. In addition, patients with positive lymph node status showed improved local recurrence-free survival following ext-LND (p=0.0425).
Conclusion: Ext-LND can be considered a quality marker of LND in melanoma patients.
KW  - Lymphadenektomie
KW  - axilläre
KW  - inguinale Lymphadenektomie
KW  - malignes Melanom
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-211539
ER  - 
TY  - JOUR
A1  - Baur, Johannes
A1  - Mathe, Katrin
A1  - Gesierich, Anja
A1  - Weyandt, Gerhard
A1  - Wiegering, Armin
A1  - Germer, Christoph-Thomas
A1  - Gasser, Martin
A1  - Pelz, Jörg O. W.
T1  - Morbidity and oncologic outcome after saphenous vein-sparing inguinal lymphadenectomy in melanoma patients
JF  - World Journal of Surgical Oncology
N2  - Background:
Inguinal lymph node dissection (LND) is a surgical procedure with a high morbidity rate. Variations in surgical procedure, such as sparing of the saphenous vein, have been proposed to reduce surgical morbidity. While sparing of the saphenous vein has shown promising results in earlier studies, data for this procedure in melanoma patients are rare. In this retrospective study, we report 10-year findings on the effects of saphenous vein-sparing LND on surgical morbidity and oncologic outcomes in melanoma patients.
Methods:
A retrospective analysis of melanoma patients receiving inguinal LND in our facility between 2003 and 2013 was performed. Patients were divided into two groups: the saphenous vein resection group and the vein sparing group. Surgical morbidity, including wound infection, lymphatic fistula, severe bleeding, neurological complications, and chronic lymphedema, as well as regional recurrence-free survival were investigated.
Results:
A total of 106 patients were included in this study; of these, the saphenous vein was spared in 41 patients (38.7%). The rate of lymphatic fistula was 51.6 vs. 48.8%, wound infection occurred in 31.3 vs. 24.4%, and patients suffered from chronic lymphedema in 30.0 vs. 26.5% in V. saphena magna resection vs. sparing group. Differences observed, however, were not significant. No difference in regional recurrence-free survival between the two study groups was detected.
Conclusions:
The results of our retrospective analysis could not confirm the promising results reported in earlier studies. Thus, sparing of the saphenous vein appears to be optional.
KW  - malignant melanoma
KW  - inguinal lymph node dissection
KW  - regional recurrence
KW  - V. saphena magna
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-157687
VL  - 15
IS  - 99
ER  -