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Superficial Inguinal Lymph Node Dissection

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Superficial Inguinal Lymph Node Dissection

Posted By
2/18/2020 3:24pm
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Replies: 4

2008 -- Melanoma in situ (lower right leg)
2015 -- Melanoma 2B upper right leg (Sentinel Node Negative)

2020 -- CT scan showed swollen right groin lymph node -- Biopsy confirms Melanoma -- now stage 3b

Treatment plan is Opdivo/Yervoy -- followed by a Superficial Inguinal Lymph Node Dissection
(Lymph node with checked along the way to evaluate effectiveness of Immunotherapy)

Surgeon also recommended a Plastic Surgeon work WITH him to o perform a Lymphovenous Bypass during Superficial Inguinal Lymph Node Dissection to lower the risk of lymphedema.
(veins are used for fluid drainage)
It's my understanding that this surgery has mostly helped alleviate lymphedema from PREVIOUS surgeries. This surgeon tries to prevent it.

Now the plot twist:
Met with the plastic surgeon today.
He is concerned that a Lymphovenous Bypass on the right side will drain fluid from the right leg directly into the veins without "filters".
This is concerning should I still have melanoma cells in the right leg or have a recurrence there in the future.

He would like to consider a Lymph Node Transfer during the Superficial Inguinal Lymph Node Dissection.
Lymph nodes will be taken from my left underarm and placed in the right leg

He said this surgery has successfully helped alleviate lymphedema in patients experiencing swelling from a previous surgery, but there is not a lot of outcome evaluation for patients getting this surgery DURING Superficial Inguinal Lymph Node Dissection.

Has anyone had this surgery?
Those who have had Superficial Inguinal Lymph Node Dissection -- what should I be considering?

My thinking:
Priority #1
Do everything possible to minimize melanoma spread/recurrence

Priority #2
Try not to end up with life-long leg swelling

This doesn't directly answer your question, but as 3c. I was prescribed nivo ONLY by 2 different docs. Most who post here are doing nivo only for 3c.

I thought long and hard about CLNB. My surgical onc and onc weren't that helpful in making a decision but seemed relieved that I decided against anything more that SLN removal. I made my decision based on the logic that if immo worked, then other LN would not get involved and I could at a later date have them removed if need be. In discussion with docs, this line of thinking didn't emanate from them. It seems they are stuck on prescriptions based on studies. I get that. When I explained my reasoning they nodded in agreement. It appeared to me they simply didn't want to say one way or the other. The thought occurred to me it was a question of liability.

Have you asked the melanoma experts at Moffitt about this?

Getting an appointment at Moffitt required an official biopsy report.
I just received that report on Monday so am looking forward to getting that appointment VERY soon.

SO appreciate your interactions and encouragement here. Thanks so much.

Appointment at Moffitt in early March