• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Dermatology

Complete dissection does not increase survival for sentinel-node positive melanoma patients

byDayton McMillan
June 13, 2017
in Dermatology, Oncology, Surgery
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Patients with melanoma and positive sentinel lymph-nodes treated with immediate completion lymph-node dissection did not have increased melanoma related survival at three years compared to patients who were followed-up with observation and nodal ultrasound.

2. Those patients who underwent completion dissection did have better rates of regional disease control compared to the observation group.

Evidence Rating: 1 (Excellent)

Study Rundown: Melanoma patients often undergo sentinel lymph node biopsies, as they experience fewer recurrences than patients who have wide excision and nodal observation. Treatment with immediate completion lymph-node dissection is often recommended for patients with positive sentinel lymph-nodes, though there is a lack of convincing evidence for this practice. Given the possible adverse events of complete dissection, further evaluation is warranted. In this study, completion lymph-node dissection was compared to observation and frequent nodal ultrasounds for melanoma patients with positive sentinel lymph-nodes.

In this international phase three trial, patients were randomized into dissection and observation plus ultrasound groups. They were followed to assess for a primary outcome of melanoma-related survival, and secondary outcomes such as disease-free survival and metastasis-free survival. Outcomes were compared at 3 years. At 3 years follow-up there was no significant difference in melanoma-specific survival between the two groups. Disease-free survival and regional disease control rates were higher in the dissection group compared to the observation group. Lymphedema as an adverse outcome was more common in the dissection group. These results indicate that completion dissection does not improve survival for melanoma patients with positive sentinel nodes if patients can follow-up with providers regularly for nodal evaluations and ultrasounds.

Click to read the study, published in NEJM

Relevant Reading: Sentinel-node biopsy or nodal observation in melanoma

RELATED REPORTS

#VisualAbstract: Dermatopathologists have varying perceptions on whether the overdiagnosis of different melanocytic skin lesions is a public health issue

#VisualAbstract: Melanoma is projected to remain an important global health concern in 2040, with high incidence rates in fair-skinned populations of European descent

#VisualAbstract: Solid organ transplant recipients are at an increased risk of developing non-melanoma skin cancers

In-Depth [randomized controlled trial]: This phase three randomized trial (Multicenter Selective Lymphadenectomy Trial II, MSLT-II) involved 63 international centers and enrolled patients from 2004 to 2014. Patients enrolled had localized cutaneous melanoma and sentinel lymph-node metastasis confirmed by either pathology or RT-PCR (reverse-transcriptase–polymerase-chain-reaction). They were then randomized in a 1:1 manner to a completion lymph-node dissection (n = 967 intention-to-treat (ITT), n = 824 per-protocol (PP)) or nodal observation with ultrasound monitoring (n = 967 ITT, n = 931 PP) group. In the observation group, clinical exams and ultrasounds occurred during the first 3 years of follow-up at 4-6 month intervals. Many more patients declined completion dissection (n = 140) than observation (n = 29). The primary end-point of analysis was melanoma-specific survival, and secondary endpoints included disease-free survival and disease control. At 3 years follow-up, the PP analysis showed no difference in melanoma-specific survival between the dissection and observation groups (86±1.3% and 86±1.2%, respectively; p = 0.42). The rate of disease-free survival was greater in the dissection group compared to the observation group (68±1.7% and 63±1.7%, respectively; p = 0.05), as was the rate of disease control in regional lymph nodes (92±1.0% and 77±1.5%, respectively, p < 0.001). Nodal recurrence occurred 69% less in the dissection group compared to the observation group (hazard ratio 0.31; 95%CI 0.24 to 0.41; p < 0.001). Lymphedema occurred more in the dissection group (24.1% vs 6.3%, respectively; p < 0.001).

Image: PD

©2017 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: melanomametastatic melanoma
Previous Post

Lithium during pregnancy linked to modest increase in cardiac malformations

Next Post

2 Minute Medicine Rewind June 12, 2017

RelatedReports

#VisualAbstract: Dermatopathologists have varying perceptions on whether the overdiagnosis of different melanocytic skin lesions is a public health issue
StudyGraphics

#VisualAbstract: Dermatopathologists have varying perceptions on whether the overdiagnosis of different melanocytic skin lesions is a public health issue

April 28, 2022
#VisualAbstract: Melanoma is projected to remain an important global health concern in 2040, with high incidence rates in fair-skinned populations of European descent
StudyGraphics

#VisualAbstract: Melanoma is projected to remain an important global health concern in 2040, with high incidence rates in fair-skinned populations of European descent

April 14, 2022
#VisualAbstract: Solid organ transplant recipients are at an increased risk of developing non-melanoma skin cancers
StudyGraphics

#VisualAbstract: Solid organ transplant recipients are at an increased risk of developing non-melanoma skin cancers

April 12, 2022
#VisualAbstract: Melanoma may be considerably over-diagnosed in white patients in the US
StudyGraphics

#VisualAbstract: Melanoma may be considerably over-diagnosed in white patients in the US

March 24, 2022
Next Post
Factors contributing to parents providing alcohol sips to adolescents

2 Minute Medicine Rewind June 12, 2017

PCI not superior to medical therapy alone in stable coronary disease: The COURAGE study

New standardized score identifies patients who should be treated with shorter duration dual-antiplatelet therapy

Pediatric DKA associated with recent acute care visits

HbA1c overestimates mean glucose in black persons compared with whites

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • APOEε4 genotype may increase risk of chronic traumatic encephalopathy following repetitive head impact
  • The RAPTURE trial: Radiofrequency ablation effective and safe in lung cancer [Classics Series]
  • Relugolix combination therapy is efficacious for endometriosis-associated pain
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.