In a nutshell
This study investigated whether complete lymph node removal in patients with positive sentinel lymph node biopsy (SLNB) improved survival. Researchers suggested that complete lymph node removal is not associated with improved survival.
Some background
SLNB is a procedure used to detect lymph node metastasis (spread of disease) in melanoma patients. Lymph node metastasis increases the risk of the cancer spreading to other areas fo the body. Lymph node removal by surgery is the recommended treatment for patients with positive SLNB. However, the role of complete lymph node removal in improving patient’s survival remains unclear.
Methods & findings
The objective of this study was to investigate whether complete lymph node removal in positive SLNB patients was associated with improved survival. This study included 473 melanoma patients with positive SLNB. Of these 242 underwent complete lymph node removal. The average follow-up period was 35 months. 66% of patients had a metastasis that was less than 1 mm in size.
Metastasis-free survival (time from start of treatment to first distant metastasis), recurrence-free survival (time from treatment to first recurrence) and overall survival (OS; time from treatment to death by any cause) were determined.
Distant metastasis occurred in 85 (18%) of the 483 patients. 42 patients with distant metastasis underwent lymph node removal.
Distant metastasis-free survival at 3 years was 77% in patients who did not undergo lymph node removal and 74.9% in patients who did. 3-year OS was 81.7% in patients who did not undergo lymph node removal and 81.2% in patients who did. 3-year recurrence-free survival was 67.4% in patients who did not undergo lymph node removal and 66.8% in patients who did.
The bottom line
This study determined that complete lymph node removal in positive SLBN melanoma patients was not associated with improved recurrence, metastasis or survival rates.
The fine print
This trial ended early due to a low number of distant metastases. Further studies with larger patient populations should be run.
Published By :
The Lancet. Oncology
Date :
May 05, 2016
