Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country
Background. Advanced stages of plantar acral lentiginous melanoma are common in Africa. Inguinal lymph node dissection (ILND) in these cases plays a critical role in disease-free and overall survival. Our study aims to share our experience in ILND for advanced plantar melanomas. Methods and Study De...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Journal of Skin Cancer |
| Online Access: | http://dx.doi.org/10.1155/2020/8854460 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832550874226884608 |
|---|---|
| author | Ollo Roland Somé Malick Diallo Damien Konkobo Nassirou Yabré Valentin Konségré Issouf Konaté Sidy Ka |
| author_facet | Ollo Roland Somé Malick Diallo Damien Konkobo Nassirou Yabré Valentin Konségré Issouf Konaté Sidy Ka |
| author_sort | Ollo Roland Somé |
| collection | DOAJ |
| description | Background. Advanced stages of plantar acral lentiginous melanoma are common in Africa. Inguinal lymph node dissection (ILND) in these cases plays a critical role in disease-free and overall survival. Our study aims to share our experience in ILND for advanced plantar melanomas. Methods and Study Design. Four-year prospective study. Patients. We included all documented cases of advanced stage plantar melanoma with clinically detectable inguinal lymph node metastasis. Twenty-two of 27 patients identified—with mean age 56 years—underwent ILND. Studied Variables. Tumor patterns and stage, surgery, morbidity, oncologic pathology, and evolution were studied. Statistical software assessed the overall survival (OS). Results. Plantar lesions were all excised with a cancer-free margin (3 cm). ILND was performed for 22 patients with visible (n = 11), palpable (n = 7), and ulcerous (n = 4) lymphadenopathies. It was performed through an S-shaped (n = 11) or ellipse-shaped skin incision (n = 11). The tumors were AJCC stage III (n = 18) and IV (n = 2). We found high Breslow index tumor thickness (>3 mm) and an advanced Clark IV stage (n = 20). All operative wounds healed within 46 days (21–90). Wound healing was delayed by suture failure (n = 16), lymphorrhoea (n = 22), and infection (n = 18). After 29 months, three patients had complete remissions, seven had recurrences, and twelve patients had died. The overall survival (OS) at one year was 56%. In two patients with AJCC stage III disease, the OS was better (22 months). Conclusion. In low-income countries, ILND in advanced stages of plantar foot melanoma is a valuable surgical treatment option. Alongside ILND adjuvants, treatment must be available and accessible to improve survival. |
| format | Article |
| id | doaj-art-e9c0f6b7e2fb428088438295ba0e2b7a |
| institution | Kabale University |
| issn | 2090-2905 2090-2913 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Skin Cancer |
| spelling | doaj-art-e9c0f6b7e2fb428088438295ba0e2b7a2025-02-03T06:05:35ZengWileyJournal of Skin Cancer2090-29052090-29132020-01-01202010.1155/2020/88544608854460Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income CountryOllo Roland Somé0Malick Diallo1Damien Konkobo2Nassirou Yabré3Valentin Konségré4Issouf Konaté5Sidy Ka6General Surgery Department, CHU Sourô Sanou (Burkina Faso), Bobo-Dioulasso, Burkina FasoOrthopedic Surgery and Traumatology Department, CHU Sourô Sanou (Burkina Faso), Bobo-Dioulasso, Burkina FasoJolliot Curie Cancer Institute, CHU Dantec (Sénégal), Dakar, SenegalGeneral Surgery Department, CHU Sourô Sanou (Burkina Faso), Bobo-Dioulasso, Burkina FasoBiology Department, CHU Sourô Sanou (Burkina Faso), Bobo-Dioulasso, Burkina FasoDermatology Department, CHU Sourô Sanou of Bobo-Dioulasso (Burkina Faso), Bobo-Dioulasso, Burkina FasoJolliot Curie Cancer Institute, CHU Dantec (Sénégal), Dakar, SenegalBackground. Advanced stages of plantar acral lentiginous melanoma are common in Africa. Inguinal lymph node dissection (ILND) in these cases plays a critical role in disease-free and overall survival. Our study aims to share our experience in ILND for advanced plantar melanomas. Methods and Study Design. Four-year prospective study. Patients. We included all documented cases of advanced stage plantar melanoma with clinically detectable inguinal lymph node metastasis. Twenty-two of 27 patients identified—with mean age 56 years—underwent ILND. Studied Variables. Tumor patterns and stage, surgery, morbidity, oncologic pathology, and evolution were studied. Statistical software assessed the overall survival (OS). Results. Plantar lesions were all excised with a cancer-free margin (3 cm). ILND was performed for 22 patients with visible (n = 11), palpable (n = 7), and ulcerous (n = 4) lymphadenopathies. It was performed through an S-shaped (n = 11) or ellipse-shaped skin incision (n = 11). The tumors were AJCC stage III (n = 18) and IV (n = 2). We found high Breslow index tumor thickness (>3 mm) and an advanced Clark IV stage (n = 20). All operative wounds healed within 46 days (21–90). Wound healing was delayed by suture failure (n = 16), lymphorrhoea (n = 22), and infection (n = 18). After 29 months, three patients had complete remissions, seven had recurrences, and twelve patients had died. The overall survival (OS) at one year was 56%. In two patients with AJCC stage III disease, the OS was better (22 months). Conclusion. In low-income countries, ILND in advanced stages of plantar foot melanoma is a valuable surgical treatment option. Alongside ILND adjuvants, treatment must be available and accessible to improve survival.http://dx.doi.org/10.1155/2020/8854460 |
| spellingShingle | Ollo Roland Somé Malick Diallo Damien Konkobo Nassirou Yabré Valentin Konségré Issouf Konaté Sidy Ka Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country Journal of Skin Cancer |
| title | Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country |
| title_full | Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country |
| title_fullStr | Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country |
| title_full_unstemmed | Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country |
| title_short | Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country |
| title_sort | inguinal lymph node dissection for advanced stages of plantar melanoma in a low income country |
| url | http://dx.doi.org/10.1155/2020/8854460 |
| work_keys_str_mv | AT ollorolandsome inguinallymphnodedissectionforadvancedstagesofplantarmelanomainalowincomecountry AT malickdiallo inguinallymphnodedissectionforadvancedstagesofplantarmelanomainalowincomecountry AT damienkonkobo inguinallymphnodedissectionforadvancedstagesofplantarmelanomainalowincomecountry AT nassirouyabre inguinallymphnodedissectionforadvancedstagesofplantarmelanomainalowincomecountry AT valentinkonsegre inguinallymphnodedissectionforadvancedstagesofplantarmelanomainalowincomecountry AT issoufkonate inguinallymphnodedissectionforadvancedstagesofplantarmelanomainalowincomecountry AT sidyka inguinallymphnodedissectionforadvancedstagesofplantarmelanomainalowincomecountry |