Experts debate role of completion lymphadenectomy for node-positive melanoma

Source: Healio.com/hematology-oncology, March 2016

NEW YORK — Two speakers debated whether completion lymphadenectomy is still standard of care for patients with sentinel lymph-node positive melanoma at HemOnc Today Melanoma and Cutaneous Malignancies.

The ASCO/Society of Surgical Oncology joint guidelines on sentinel lymph node biopsy (SLNB) recommend completion lymph node dissection (CLND) for any positive node. Further, evidenced-based guidelines from the National Comprehensive Cancer Network state CLND should be discussed and offered for patients with stage III, lymph node-positive disease.

“These guidelines often offer precious little in the way of actual guidance, in part because they include a use of words that don’t really help us understand what we are supposed to do,” Vernon K. Sondak, MD, chair of the department of cutaneous oncology at Moffitt Cancer Center and a HemOnc Today Editorial Board member, said during his presentation. “Do we ‘discuss,’ ‘offer,’ ‘recommend?’ Is it ‘indicated,’ ‘necessary,’ ‘beneficial?’ What are we really trying to say?”