Poll – Did you have full or partial dissection?

[bubbasmomma]

For those of us who have struggled with whether or not to proceed with full or partial dissection, it would be helpful to know what others decided and the results.

It would be great if you could provide the following:

Type:

Location:

Margins Free?:

Depth:

Ulceration:

Mitotic Rate:

SNB results:

Full or Partial dissection results: If applicable, I am interested in knowing if the nodes removed were clear. Or, was it not offered? Or did you decline?

For me:

Type: Malignent melanoma, superficial spreading type

Location: Left inner knee

Margins Free?: Yes

Depth: 1.05mm

Ulceration: absent

Mitotic Rate: 2/mm2

SNB results: 2 lymph nodes removed from left groin, of which 1 had micromestasis

Full or Partial results: Partial dissection offered, but declined. Interferon declined.

Thanks

[Linny]

Type: Malignant Metastatic Melanoma

Location: Unknown

Margins Free?:N/A

Depth: N/A

Ulceration: No

Mitotic Rate: Don’t know

SNB results: N/A with an explanation. I was not eligible for the SNB because my primary was unknown.

Full or Partial dissection results: If applicable, I am interested in knowing if the nodes removed were clear. Or, was it not offered? Or did you decline? I had two surgeries to remove lymph nodes. The first was to remove a very large lymph node (6-8cm) in which abnormal cells were found after a needle biopsy. At the same time, my local surgeon also removed another enlarged lymph node that was smaller than the big bad one. Melanoma was found in the big bad one. The other node was a reactive node. A subsequent CAT scan revealed no other spread but because I had the unknown primary, I was referred to Johns Hopkins, where the plan was to remove the rest of the lymph nodes under that arm and biopsy them. After the surgery done at Hopkins, the rest of the nodes were found to be clean.

[colleen66]

Location, left leg, inner knee.

Breslow, 4.5

Miotic, 100

Margins, clear after wle

SLNB, 1 with micro, encapsulated

I chose the to have the surface nodes removed. 7 were taken.

Started interferon, lasted 3 weeks of high dose. Doctor canceled rest of protocol due to severe effects.

If lymphedema is a concern for you, I still got it pretty bad even with the surface ones removed. It is a manageable condition.

[washoegal]

Type: Metastatic Melanoma

Location: Right Flank

Margins Free?: Yes

Depth: 3.0

Ulceration:No

Mitotic Rate: 15mm

SNB results:2 node with micro-metases out of 4

Full or Partial dissection results: Full dissection (partial not offered). 26 removed – all were clear. Interferon declined.

[msue5]

Nodular Lt inner thigh

Breslow 3.0

Ulceration no

Mitosis 8

SNB neg

I had WLE and SNB in Feb 2010 and had an enlarged lt groin node in Dec 2010. Complete Dissection done and 17 nodes removed. All neg except diseased node which had extra capsular extension. I got an infection 10 days post op and excision dehissed (split open). I was left with huge gaping wound. It had to be packed twice daily. Could fit entire roll of gauze soaked in saline into wound. In Feb a plastic surgeon performed a flap surgery in which he made an incision vertically and removed skin, tissue and muscle from rt abd and moved it underneath to fill open wound. Very difficult surgery and a year later had Abd reconstruction to remove mesh used in flap surgery because it calcified and turned rock hard. This was a year ago and I am stil in pain and have a hernia at the top of my Abd scar. Moderate lymphedema with chronic on and off sciatic and groin pain. Would I do it differently given what I know? If I had micro mets I think I would opt to only remove diseased node and monitor with ultra sounds. Despite going through this I am now stage 4. So in the end the surgery didn’t help. I was supposed to get Radiation to the groin after dissection but open wounds prevented that. I know my results aren’t typical but this surgery should not be taken lightly nor do I think it should be standard of care. I now have an enlarged node in rt axilla and there is no way I would have an axillary dissection in my dominant arm. As one Dr said I had a groin dissection with catastrophic results. My Dr.s or care were not at fault. It was just a series of very bad luck. There are many more positive stories than mine. I just want you to know the risks so you can make an informed decision. I think dissections are overkill in most cases.

Mary Sue

radiation to the groin after dissection but had the open wounds and could

not do it. Maybe that would have prevented me from becoming stage 4.

[msue5]

Messed up at the bottom. Sorry

Mary Sue

[Author]

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