Is ultrasound surveillance of lymph nodes safe in patients with medium-risk melanoma?

This study wanted to find out if performing ultrasounds and performing clinical exams is a safe option to catch cancer that has spread to the lymph nodes in patients with melanoma. The study found that a significant number of tumors were found in lymph nodes by performing this type of surveillance.

The most common place for melanoma cancer to spread to is the lymph nodes. This can happen long after the cancer is initially treated. Because of this, it is important to monitor the lymph nodes to make sure cancer has not spread.

There are a number of ways to monitor. One way is just to perform a clinical exam, where the doctor will feel for lumps in the lymph nodes. Another way is to do ultrasounds on the area. A final option would be to remove the lymph nodes completely, as a precaution. It is not known which of these options is the best to catch the cancer before it spreads further. 

This study had 90 patients. All patients had melanoma that was between 1.2-3.5mm thick. They all had surgery to remove the tumor, as well as a margin of surrounding skin. The patients had ultrasound scans of the lymph nodes near where the cancer had been. These occurred every 3 months in the first year, every 4 months in the second and third years, and every 6 months in the fourth and fifth years. Patients were followed up for an average of 52 months. 

After 5 years, 94% of patients were still alive. At this time, 73% of patients did not experience disease worsening.

Overall, 22% of patients had a relapse. During the follow-up, ten patients were found to have cancer in the lymph nodes. Four patients were found to have cancer that had spread outside of the lymph nodes. Six patients had cancer that had spread to other distant parts of the body.

The study concluded that using ultrasound scans is an effective way to watch for cancer in the lymph nodes that may have spread from a melanoma. 

This was a small study. It did not compare the results of two different types of treatment.

Talk to your oncologist about your plan for surveillance of lymph nodes.