Assessment of complete lymph node dissection in patients with melanoma:A systemic review and meta-analysis

Background: Complete lymph node dissection(CLND) for patients with melanoma remains controversial. This meta-analysis aimed to compare the prognoses and complications between the CLND and control groups(patients who receive adjuvant treatment or observation only) in patients with sentinel lymph node(SLN)-positive melanoma.Methods: The Pub Med, Embase, Cochrane, and Web of Science databases were searched for cohort studies and randomized clinical trials(RCTs) conducted between 1964 and 2022, and the quality of the studies was assessed using the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale. Hazard ratios(HR) or risk ratios(RR) with 95%confidence intervals(CIs) were calculated for each outcome. Heterogeneity and sensitivity tests were also conducted, and publication bias tests were performed when the pooled number of studies was >10.Results: Fifteen studies, including 11 cohort studies and 4 RCTs, were enrolled and assessed for quality. Analysis of overall survival showed no significant difference between the CLND and control groups(HR=1.02, 95% CI:0.69–1.51, P=0.922). Similarly, recurrence-free survival(HR=0.84, 95% CI: 0.6–1.16, P=0.287), disease-free survival(HR=1.06, 95% CI: 0.65–1.72, P=0.82), and disease-specific survival(HR=0.84, 95% CI: 0.59–1.21,P=0.355) showed no difference between the two groups. CLND did not reduce the risk of recurrence(RR=0.98,95% CI: 0.8–1.2, P=0.851).Conclusion: Remarkably, patients who underwent CLND were more likely to have complications such as flap necrosis and lymphedema than the controls. CLND does not improve patient prognosis and may increase the incidence of complications.

Re-Exploring Biomarkers and Therapeutic Targets in Primary Melanoma Patients: Insights from Network-Based Analysis of Microarray Data

Objective To identify novel biomarkers and therapeutic targets for primary melanoma using network-based microarray data analysis.Methods Eligible microarray datasets from the Gene Expression Omnibus(GEO)database were used to identify differentially expressed genes(DEGs).The protein-protein interaction(PPI)network,Gene Ontology(GO),and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses were performed to identify hub genes and pathways that might affect the survival of melanoma patients.Immunohistochemistry results obtained from the Human Protein Atlas(HPA)database confirmed the protein expression levels of hub genes.The Cancer Genome Atlas(TCGA)database was used to further verify the gene expression levels and conduct survival analysis.Results Three microarray datasets(GSE3189,GSE15605,and GSE46517)containing 122 melanoma and 30 normal skin tissue samples were included.A total of 262 common differentially expressed genes(cDEGs)were identified based on three statistical approaches(Fisher’s method,the random effects model(REM),and vote counting)with strict criteria.Of these,two upregulated genes,centromere protein F(CENPF)and pituitary tumortransforming gene 1(PTTG1),were selected as hub genes.HPA and TCGA database analyses confirmed that CENPF and PTTG1 were overexpressed in melanoma.Survival analysis showed that high expression levels of CENPF were significantly correlated with decreased overall survival(OS)(P=0.028).Conclusion The expression level of CENPF was significantly upregulated in melanoma and correlated with decreased OS.Thus,CENPF may represent a novel biomarker and therapeutic target for melanoma patients.