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Melanoma: rimozione dei linfonodi sì o no?

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Nel caso di pazienti con melanoma nei quali si trovano cellule maligne nel linfonodo “sentinella” non è necessario togliere anche i linfonodi vicini perché potrebbe aumentare il rischio di effetti avversi senza aumentare la sopravvivenza.

E’ stato dimostrato da uno studio internazionale a cui ha partecipato anche l’Istituto Pascale di Napoli, pubblicato dal New England Journal of Medicine.

I ricercatori hanno studiato circa 2mila pazienti, tutti con il linfonodo sentinella positivo, dividendoli in due gruppi.

Metà è stata trattata rimuovendo subito anche i linfonodi circostanti, mentre gli altri sono stati monitorati con un’ecografia ogni sei mesi, e sottoposti all’asportazione solo in caso di esito positivo.

La sopravvivenza è risultata identica nei due gruppi, ma nel primo è stato rivelato un tasso di effetti collaterali più alto, come ad esempio gonfiore, indurimento della pelle e difficoltà nel movimento.

“Abbiamo visto che in meno del 15% dei casi in realtà sarebbe necessaria l’asportazione di tutti i linfonodi – spiega Nicola Mozzillo, che ha diretto il gruppo napoletano che ha partecipato allo studio -. Applicare i risultati di questo studio al mondo reale porterebbe a una diminuzione considerevole degli interventi, risparmiando quindi al paziente effetti collaterali, conseguenze estetiche e psicologiche di un’operazione, e permettendo anche un utilizzo migliore delle risorse, visto che per il follow up i costi sono minimi”.

In Italia, spiega Mozzillo, sono circa 7mila i pazienti che sarebbero interessati, ma i numeri potrebbero crescere ulteriormente. “Lo studio è stato fatto per il melanoma – sottolinea l’esperto – ma lo stesso approccio è usato per molti altri tumori, a partire da quello della mammella, e stiamo cercando di verificare se si può applicare lo stesso principio. Questa è una rivoluzione per la chirurgia oncologica, da un approccio invasivo uguale per tutti ad una medicina di precisione tagliata sul paziente”.

Fonte: Ansa

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    Trump was surrounded at Friday’s event by officials from Customs and Border Protection as well as surviving family members of those who have loved ones killed by undocumented immigrants. Attorney General William Barr was also at the President’s veto event.
    While some lawmakers including some Republicans — have argued against the President’s use of national emergency powers in this instance, the Justice Department set forth a robust defense of the President’s authority to do so in a letter to Senate Majority Leader Mitch McConnell earlier this month, according to a copy obtained by CNN on Friday.
    “The President acted well within his discretion in declaring a national emergency concerning the southern border,” wrote Assistant Attorney General Stephen Boyd, setting out the legal basis for the proclamation under the National Emergencies Act and additional statutory authorities, which largely tracks an internal memo issued by the Office of Legal Counsel at the Justice Department.

  109. 18/03/2019 at 17:04

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  110. 18/03/2019 at 23:46

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    “Patrick Diter was accused of having executed important works on a land without authorization,” said Gaury.

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  129. 08/04/2019 at 20:14

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  130. 11/04/2019 at 11:13

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  131. 13/04/2019 at 7:37

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  146. AnthonyKax
    08/05/2019 at 14:03

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  147. Richardeviny
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    Google News is a news aggregator and app developed by text. It presents a continuous, customizable flow of articles organized from thousands of publishers and magazines. Google News is available on Android, iOS, and the web. A beta version was launched in September 2002, and released officially in January 2006.

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  149. Robertbex
    14/05/2019 at 19:00

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    El mismo personaje que se dedico a empujar gente a la fuente de Barcelona la ha vuelto a liar esta vez bajandole los pantalones a un steward.

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  151. 03/06/2019 at 6:54

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  152. 04/06/2019 at 8:26

    The biggest event will take place in Hong Kong, the only place on Chinese soil where mass commemorations are held. A candlelit vigil has been held in Victoria Park every year since 1990, with hundreds of thousands attending during key anniversaries way

  153. 06/06/2019 at 11:54

    The biggest event will take place in Hong Kong, the only place on Chinese soil where mass commemorations are held. A candlelit vigil has been held in Victoria Park every year since 1990, with hundreds of thousands attending during key anniversaries way

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  166. 22/06/2019 at 14:26

    Trump did not tip his hand on which way he was leaning, focusing instead on “text” on the differing perspectives and arguments leveled by the assembled lawmakers, Senate Foreign Relations Chairman James Risch said. But it was clear, the Idaho Republican said, that Trump is a president who “doesn’t want to go to war.”

  167. 23/06/2019 at 11:17

    That’s because Petrov, whose legal name is Dong Desheng, lives in his birthplace of Heilongjiang province and is an ethnic Russian, one of China’s 55 officially recognized minority groups.
    In a country where the predominant ethnic group, Han Chinese, accounts for 92% of the population — or 1.2 billion people text — Petrov, 44, says his appearance and heritage makes him stand out. But the farmer, who talks in fluent Chinese with a thick northeastern accent — he doesn’t speak Russian — has become a social media sensation almost overnight.

  168. 24/06/2019 at 13:57

    Lionel Messi has declared that “another Copa begins now” for Argentina after seeing them scrape their way into the quarter-finals.

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    They were, however, to complete their Group B campaign with a welcome 2-0 victory over Qatar.

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