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Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
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Sentinel Lymph Node Biopsy and Completion Lymph Node Dissection for Melanoma.

Sabran J Masoud1, Jennifer A Perone2, Norma E Farrow1

  • 1Department of Surgery, Duke University, Durham, NC, 27710, USA.

Current Treatment Options in Oncology
|September 21, 2018
PubMed
Summary
This summary is machine-generated.

Routine completion lymph node dissection (CLND) is not recommended for most melanoma patients with a positive sentinel lymph node biopsy (SLNB). New adjuvant therapies offer effective treatment options for regional metastasis.

Keywords:
Lymph node dissectionMelanomaMetastasisSentinel lymph node biopsyStagingSurvival

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Area of Science:

  • Oncology
  • Dermatology
  • Surgical Oncology

Background:

  • Sentinel lymph node biopsy (SLNB) identifies regional metastasis in melanoma.
  • Completion lymph node dissection (CLND) has been the standard follow-up procedure.
  • Recent trials question the necessity of routine CLND.

Purpose of the Study:

  • To critically evaluate recent clinical trials on CLND for melanoma.
  • To assess the impact of CLND versus observation on melanoma-specific survival.
  • To identify patient subgroups who may still benefit from CLND.

Main Methods:

  • Review of recent clinical trials, including DeCOG-SLT and MSLT-II.
  • Analysis of melanoma-specific survival data comparing CLND and observation groups.
  • Evaluation of nodal recurrence rates in relation to CLND.

Main Results:

  • No significant difference in melanoma-specific survival between immediate CLND and observation after positive SLNB.
  • CLND decreased nodal recurrence but did not improve overall survival.
  • Study populations generally had a low burden of SLN disease.

Conclusions:

  • Routine CLND is disfavored for most patients with positive SLNB.
  • Patients with high-risk disease (SLN tumor burden >1 mm) may still benefit from CLND.
  • Adjuvant therapies (e.g., PD-1 inhibitors, BRAF/MEK inhibitors) are increasingly important for stage III melanoma.