Abstract

CancerVolume 49, Issue 11 p. 2420-2430 ArticleFree Access Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities U. Veronesi, U. Veronesi Istituto Nazionale Tumori, Milan, ItalySearch for more papers by this authorJ. Adamus, J. Adamus Oncological Institute, Gliwice, PolandSearch for more papers by this authorD. C. Bandiera, D. C. Bandiera Hospital A. C. Camargo, Sao Paolo, BrazilSearch for more papers by this authorI. O. Brennhovd, I. O. Brennhovd Norwegian Radium Hospital, Oslo, NorwaySearch for more papers by this authorE. Caceres, E. Caceres Instituto Nacional de Enfermedades Neoplasicas, Lima, PeruSearch for more papers by this authorDr. N. Cascinelli, Corresponding Author Dr. N. Cascinelli Istituto Nazionale Tumori, Milan, ItalyIstituto Nazionale Tumori, Via G. Venezian 1, 20133 Milano, Italy===Search for more papers by this authorF. Claudio, F. Claudio Fondazione Pascale, Naples, ItalySearch for more papers by this authorR. L. Ikonopisov, R. L. Ikonopisov Oncological Research Institute, Sofia, BulgariaSearch for more papers by this authorV. V. Javorski, V. V. Javorski Cancer Research Centre of the USSR Academy of Medical Sciences, Moscow, USSRSearch for more papers by this authorS. Kirov, S. Kirov Herzen State Oncological Institute, Moscow, USSRSearch for more papers by this authorA. Kulakowski, A. Kulakowski Oncological Institute, Warsaw, PolandSearch for more papers by this authorJ. Lacour, J. Lacour Institut Gustave Roussy, Villejuif, FranceSearch for more papers by this authorF. Lejeune, F. Lejeune Institut Jules Bordet, Brussels, BelgiumSearch for more papers by this authorZ. Mechl, Z. Mechl Oncological Institute, Brno, CzechoslovakiaSearch for more papers by this authorA. Morabito, A. Morabito Istituto Nazionale Tumori, Milan, ItalySearch for more papers by this authorI. Rodé, I. Rodé State Institute of Oncology, Budapest, HungarySearch for more papers by this authorS. Sergeev, S. Sergeev Herzen State Oncological Institute, Moscow, USSRSearch for more papers by this authorE. van Slooten, E. van Slooten Het Nederlands Kankerinstituut, Amsterdam, The NederlandsSearch for more papers by this authorK. Szczygiel, K. Szczygiel Oncological Institute, Cracow, PolandSearch for more papers by this authorN. N. Trapeznikov, N. N. Trapeznikov Cancer Research Centre of the USSR Academy of Medical Sciences, Moscow, USSRSearch for more papers by this authorR. I. Wagner, R. I. Wagner Petrov Research Institute of Oncology, Leningrad, USSRSearch for more papers by this author U. Veronesi, U. Veronesi Istituto Nazionale Tumori, Milan, ItalySearch for more papers by this authorJ. Adamus, J. Adamus Oncological Institute, Gliwice, PolandSearch for more papers by this authorD. C. Bandiera, D. C. Bandiera Hospital A. C. Camargo, Sao Paolo, BrazilSearch for more papers by this authorI. O. Brennhovd, I. O. Brennhovd Norwegian Radium Hospital, Oslo, NorwaySearch for more papers by this authorE. Caceres, E. Caceres Instituto Nacional de Enfermedades Neoplasicas, Lima, PeruSearch for more papers by this authorDr. N. Cascinelli, Corresponding Author Dr. N. Cascinelli Istituto Nazionale Tumori, Milan, ItalyIstituto Nazionale Tumori, Via G. Venezian 1, 20133 Milano, Italy===Search for more papers by this authorF. Claudio, F. Claudio Fondazione Pascale, Naples, ItalySearch for more papers by this authorR. L. Ikonopisov, R. L. Ikonopisov Oncological Research Institute, Sofia, BulgariaSearch for more papers by this authorV. V. Javorski, V. V. Javorski Cancer Research Centre of the USSR Academy of Medical Sciences, Moscow, USSRSearch for more papers by this authorS. Kirov, S. Kirov Herzen State Oncological Institute, Moscow, USSRSearch for more papers by this authorA. Kulakowski, A. Kulakowski Oncological Institute, Warsaw, PolandSearch for more papers by this authorJ. Lacour, J. Lacour Institut Gustave Roussy, Villejuif, FranceSearch for more papers by this authorF. Lejeune, F. Lejeune Institut Jules Bordet, Brussels, BelgiumSearch for more papers by this authorZ. Mechl, Z. Mechl Oncological Institute, Brno, CzechoslovakiaSearch for more papers by this authorA. Morabito, A. Morabito Istituto Nazionale Tumori, Milan, ItalySearch for more papers by this authorI. Rodé, I. Rodé State Institute of Oncology, Budapest, HungarySearch for more papers by this authorS. Sergeev, S. Sergeev Herzen State Oncological Institute, Moscow, USSRSearch for more papers by this authorE. van Slooten, E. van Slooten Het Nederlands Kankerinstituut, Amsterdam, The NederlandsSearch for more papers by this authorK. Szczygiel, K. Szczygiel Oncological Institute, Cracow, PolandSearch for more papers by this authorN. N. Trapeznikov, N. N. Trapeznikov Cancer Research Centre of the USSR Academy of Medical Sciences, Moscow, USSRSearch for more papers by this authorR. I. Wagner, R. I. Wagner Petrov Research Institute of Oncology, Leningrad, USSRSearch for more papers by this author First published: 1 June 1982 https://doi.org/10.1002/1097-0142(19820601)49:113.0.CO;2-2Citations: 398AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Results of a prospective randomized clinical trial conducted by the WHO Collaborating Centers for the Evaluation of Methods of Diagnosis and Treatment of Melanoma are reported. Five-hundred-fifty-three Stage I patients whose limbs were affected entered the study; 267 were submitted to wide excision and immediate node dissection and 286 had wide excision and node dissection at the time clinically positive nodes were detected. Survival curves of the two treatment groups could be superimposed. No subsets of patients benefitted from immediate node dissection. The authors conclude that delayed node dissection is as effective as the immediate dissection in Stage I melanoma of the extremities if the patient can be checked every three months. If the quarterly follow-up is not guaranteed, immediate node dissection is advisable, at least for melanomas thicker than 2 mm. References 1 Balch MC, Murad T, Soong S, Ingalls AL, Richards PC, Maddox WA. Tumor thickness as a guide to surgical management of clinical stage I melanoma patients. Cancer 1979; 43: 883– 888. 2 Block GE, Hartwell SW Jr. Malignant melanoma—a study of 217 cases. Part I: Epidemiology. 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Malignant melanoma: a clinical study of 427 cases. Ann Surg 1965; 162: 15– 28. 19 Roses DF, Harris MN, Gumport SL. Lymph node dissection in melanoma. A letter to the Editor. N Engl J Med 1978; 298: 223. 20 Sim FH, Taylor WF, Ivins JC, Pritchard DJ, Soule EH. A prospective randomized study of the efficacy of routine elective lymph-adenectomy in management of malignant melanoma. Cancer 1978; 41: 948– 956. 21 Southwick HW, Slaughter DP, Hinkamp JF, Johnson FE. The role of regional node dissection in the treatment of malignant melanoma. Arch Surg 1962; 85: 63– 68. 22 Veronesi U, Adamus J, Bandiera DC et al. Inefficacy of immediate node dissection in stage I melanoma of the limbs. N Engl J Med 1977; 297: 627– 630. 23 Wanebo HJ, Fortner JG, Woodruff J, MacLean B, Binkowski E. Selection of the optimum surgical treatment of stage I melanoma by depth of micro invasion: Use of the combined microstage technique (Clark-Breslow). Ann Surg 1975; 182: 302– 313. 24 Wanebo HJ, Woodruff J, Fortner JG. Malignant melanoma of the extremities. A clinico pathologic study using levels of invasion (microstage). Cancer 1975; 35: 666– 676. 25 Wanebo HJ. Lymph node dissection in melanoma. A letter to the Editor. N Engl J Med 1978; 298: 222– 223. Citing Literature Volume49, Issue111 June 1982Pages 2420-2430 ReferencesRelatedInformation