Prognosis in patients with sentinel node-positive melanoma without immediate completion lymph node dissection

Area of Science:

• Oncology
• Surgical Oncology
• Melanoma Research

Background:

• The clinical benefit of immediate completion lymph node dissection (CLND) for sentinel node (SN)-positive melanoma remains uncertain.
• This study aimed to determine the impact of immediate CLND on patient outcomes in this specific melanoma subgroup.

Purpose of the Study:

• To evaluate the therapeutic value of immediate CLND in patients with SN-positive melanoma.
• To compare survival outcomes between patients who underwent CLND and those who did not.

Main Methods:

• Retrospective analysis of 1174 SN-positive melanoma patients treated between 1993-2008 across ten European Organization for Research and Treatment of Cancer Melanoma Group centers.
• Comparison of outcomes between patients who had CLND versus those who did not, utilizing univariable, matched-pair, and multivariable survival analyses.
• Assessment of prognostic factors including maximum tumor size, intranodal location, and penetrative depth of SN metastases.

Main Results:

• Of 1174 patients, 94.8% underwent CLND; 5.2% did not.
• Neither univariable nor matched-pair analyses showed a significant influence of CLND on disease-specific survival (HR 0.89, P=0.600; HR 0.86, P=0.640, respectively).
• Multivariable analyses, after adjusting for prognostic factors, also revealed no difference in survival between the groups.

Conclusions:

• Immediate CLND did not influence the outcome for patients with SN-positive melanoma in this study.
• Prognostic heterogeneity existed between the analyzed cohorts, but CLND did not alter survival.
• The findings suggest CLND may not be essential for improving survival in SN-positive melanoma patients.