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May 30, 2016 at 9:18 pm #22876TerbistiParticipant
Hello, I am trying to decide if CLND is still a good idea for micrometastases found in SLN. I have several questions that if clarified could help. Background: primary melanoma 1.9 mm on my calf. Clear margins with WLE but micrometastases found in the one node taken. PET scan will be tomorrow. Surgery would be complete removal of lymph nodes in right groin (superficial and deep)
1. I’ve seen new unfinished studies saying it doesn’t change outcomes. Are there studies showing it does?
2. How long will I need to wear compression stockings? If I’m lucky and don’t have complications, what is an expected recovery time? How long until I can drive again?
3. If I choose not to have the surgery will I still be allowed in studies?
4. If I choose the surgery is it better to have sartorius transposition if it’s an option?
5. Will the newest immunotherapy drugs be as effective without those lymph nodes should I ever move to a more advanced stage.
6. What role does mitosis rate play in determining treatments? Mine seems high at 6.
I understand that questions may not have specific answers and I plan on having this discussion with the melanoma specialist but any links to studies or personal experience would be greatly appreciated.
Thanks so much… For me this diagnosis has been very difficult and it all seems so confusing and unpredictable. I really just want to live a long healthy life and this is scary.May 30, 2016 at 10:19 pm #69005jennunicornParticipant
It is a bit long, but incredibly informative and will give you a lot of information that should help you understand stage III and all of your options.May 31, 2016 at 11:28 am #69006Catherine PooleKeymaster
There is still some controversy about CLND but with just one micro met, partial dissection or following with ultrasound would be options to discuss. Are you seeing a melanoma expert at a leading institution that does melanoma research? That is crucial. Your choice to have or not have a CLND will not affect a clinical trial criteria that I know of. To consider is the sometimes extreme quality of life issues you may face with a CLND in the future. I am hoping others here will chime in on their experience. There are no guarantees either way, but the location of your melanoma is in your favor for prognosis! Where are you going for treatment?June 2, 2016 at 4:28 pm #69007msue5Participant With micro metastisis I would opt for ultrasound surveillance. CLND is serious surgery with the potential for major complications. I had many complications and am left with some lifelong issues. My 1 pos node had what’s called extracapsular extension which means the Melanoma had consumed the node and broken through the node and was present in the soft tissue next to the node. Looking back I wished they had just removed the 1 node and what was present in the soft tissue. If it had spread to soft tissue it was going to spread even with CLND and it did making me Stage 4. All other nodes were clear as is the case with most people. I did have serious Lymphedema but used compression pump instead of wrapping. I have no idea why but my Lymphedema disappeared except in warm humid weather. I know this is your decision but wanted to point out it can have serious consequences in some people. I wish you luck with this decision. It’s a hard one to make but whatever you decide we are here to help.
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