Sentinel-Node Biopsy Can Improve Melanoma Survival
Staging procedure improves survival in patients with an intermediate-thickness primary melanoma
WEDNESDAY, Sept. 27 (HealthDay News) -- In patients with newly diagnosed melanoma, sentinel-node biopsy provides important prognostic information and identifies patients with nodal metastases whose survival can be prolonged by immediate lymphadenectomy, according to a study in the Sept. 28 issue of the New England Journal of Medicine.
Donald L. Morton, M.D., of the John Wayne Cancer Institute at Saint John's Health Center in Santa Monica, Calif., and colleagues randomly assigned 1,347 patients to either wide excision and sentinel-node biopsy with immediate lymphadenectomy if nodal micrometastases were detected on biopsy, or postoperative observation of regional lymph nodes with lymphadenectomy if nodal relapse occurred.
Among 1,269 patients with an intermediate-thickness primary melanoma, the researchers found a higher five-year disease-free survival rate in the biopsy group compared to the observation group (78.3 percent versus 73.1 percent). Among patients with nodal metastases, the researchers also found a higher five-year survival in those who underwent immediate lymphadenectomy than among those in whom lymphadenectomy was delayed (72.3 percent versus 52.4 percent).
"The results of the study by Morton et al. convincingly show that sentinel-node biopsy is a standard-of-care staging procedure and is justified in patients with melanoma with tumor thicknesses of 1.2 to 3.5 mm who have a sufficient risk of nodal metastases," state the authors of an accompanying editorial.