Sentinel lymph node biopsy after wide excision improved DFS compared with wide excision alone among patients with intermediate and thick melanomas, according to final results of the MSLT-1 trial presented at the HemOnc Today Melanoma and Cutaneous Malignancies meeting in New York.
“ ‘We found that performing sentinel lymph node biopsy is very accurate and improves staging in order to determine whether additional treatments are needed, such as additional surgery or adjuvant systemic therapy,’ Robert H.I. Andtbacka, MD, CM, FACS, FRCSC, associate professor of surgery at Huntsman Cancer Institute at the University of Utah, said during a presentation. ‘It also forms a basis for us to perform all the subsequent studies that we do in melanoma to make sure patients we have for our clinical trials are well balanced.’ “
Editor’s note: DFS stands for disease-free survival.
“Nonsentinel lymph node (NSLN) status in patients who underwent complete lymph node dissection after positive sentinel lymph node biopsy (SLNB) had independent prognostic value in patients with two to three positive lymph nodes, according to the results of a study published recently in the Journal of Clinical Oncology.
“Furthermore, researchers led by Sandro Pasquali, MD, of the University of Padova, Italy, found that patients who had metastatic disease in their NSLN had their risk for melanoma death increased by more than one-third.”
Editor’s note: Sentinel lymph nodes (those closest to the tumor) can be examined to predict whether a patient will survive melanoma. This study shows that nonsentinel lymph nodes could potentially be used for survival predictions. We covered a similar story last July.
“Cancer cell spread to the sentinel node — the lymph node to which cancer cells are most likely to spread from a primary tumor — is a risk factor for melanoma death. The prognosis of a patient largely depends on the number of disseminated cancer cells per million lymphocytes in the sentinel node. Even very low numbers were found to be predictive for reduced survival.”
The likelihood that people will survive melanoma is often based on whether the sentinel lymph nodes—those closest to the tumor—contain cancer cells. But new research suggests that the status of other nodes can also help predict survival. The researchers assessed 329 melanoma patients with ‘positive’ sentinel nodes, and found that ‘nonsentinel’ nodes were also positive in 24% of the patients. People with positive nonsentinel nodes had higher rates of tumor recurrence, and sharply lower rates of 5-year survival (46% vs 72% for those who only had positive sentinel nodes). In addition, those with positive nonsentinel nodes were also more likely to be older and to have tumors that were thicker and ulcerated.