Conservative Nodal Surgery (Node-picking) of Patients With Stage III Melanoma With Low-burden of Nodal Disease (MELCONSURG MULTICENTRE COHORT)
Study Details
Study Description
Brief Summary
Background: Standard treatment for stage III melanoma with lymph node metastases involves complete lymph node dissection, which is a radical surgical procedure aimed at the removal of the entire regional lymph node basin. Conservative surgery for low-burden nodal metastasis involves removal of the metastatic lymph node or nodes ("node-picking"), leaving uninvolved nodes within the regional basin. This is expected to provide adequate regional control of the disease with no negative impact on patient survival and a lower rate of surgical complications.
Aims: The MelConSurg Cohort will provide the first data on conservative surgery for patients with stage III melanoma with nodal metastases detected clinically or by imaging.
Methods: A multicentre, single-arm prospective cohort study. Inclusion criteria: Patients with melanoma aged between 18 and 90 years, Eastern Cooperative Oncology Group performance status 0-1, non-matted regional lymph node metastasis (N1b or N2b) in a single regional basin detected clinically or by imaging (ultrasound, CT scan, PET scan). Study period: A 3-year recruitment period and a 3-year follow-up phase.
Intervention: Patients will undergo conservative nodal surgery using conventional surgery, radio-guided surgery, or imaging guided surgery.
Outcome measures: 3-year nodal relapse-free survival, 3-year disease-free survival, 3-year melanoma-specific survival, rate of surgical complications, and quality of life (SF-36 questionnaire).
Sample size & Statistics: the estimated sample size to be recruited is 68 patients. Survival outcomes will be analysed through the Kaplan-Meier method, with the log-rank test. Conclusions: This Project is expected to provide unique evidence regarding a less radical nodal surgery for patients with melanoma. If favourable results are obtained, controlled studies could be conducted and changes in current clinical practice could be considered.
Condition or Disease | Intervention/Treatment | Phase |
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Study Design
Outcome Measures
Primary Outcome Measures
- Nodal relapse-free survival [3-year]
The primary outcome measure is the frequency and time to develop recurrence in the same nodal basin.
Secondary Outcome Measures
- Disease-free survival [3-year]
Frequency and time to develop recurrence at any site, both regional or at distance.
- Melanoma-specific survival [3-year]
Frequency and time to death directly related to melanoma progression.
- Surgical complication rate [3-year]
Frequency of long-term complications (seroma, lymphedema, nerve injury, others). health-related quality of life questionnaire.
- Quality of life [3-year]
Quality of life as tested by the SF-36 health-related quality of life questionnaire.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients with melanoma aged between 18 and 90 years.
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Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
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Nodal stage N1b or N2b (American Joint Committee on Cancer 8th edition) in a single regional basin detected clinically or by imaging (ultrasound, CT scan, PET scan).
Exclusion Criteria:
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Single lymph node metastasis in more than one regional basin.
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Multiple primary melanoma (except for limb melanoma).
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Primary occult melanoma.
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Previous nodal, locoregional, or distant metastasis.
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Previous lymph node surgery, except for SLNB.
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Distant metastases detected at the screening evaluations or first postoperative PET-CT scan.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Dermatology Department. University Hospital Virgen Macarena | Seville | Spain | 41008 |
Sponsors and Collaborators
- Hospital Universitario Virgen Macarena
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- MELCONSURG