Complete Lymph Node Dissection May Not Improve Outcomes in Melanoma
Source: Cancer Therapy Advisor, June 2018
Complete lymph node dissection (CLND) does not improve survival outcomes among patients with malignant melanoma who have positive sentinel lymph node biopsy (SLNB) compared with watchful waiting, according to an oral presentation at the 2018 American Society of Clinical Oncology Annual Meeting in Chicago, Illinois.1
SLNB is a standard procedure among patients with melanoma who are at risk of metastases, with multiple studies confirming the prognostic utility of discovering micro-metastases in the sentinel node. The diagnostic usefulness of CLND post-SLNB however, requires further investigation.
In the phase 3 DeCOG –SLT study (ClinicalTrials.gov Identifier: NCT02434107), 473 patients with melanoma were randomly assigned to undergo CLND or clinical monitoring only between January 2006 and December 2014; 240 patients were assigned to the CLND group and 233 to the monitoring group. Eligible patients had a tumor thickness of at least 1 mm and a positive SLNB with micrometastases with a maximum of 2 mm in diameter. The primary outcome was distant metastasis-free survival (DMFS), and secondary outcomes included recurrence-free (RFS) and overall survival (OS).