Sentinel Lymph Node Biopsy Should Be Considered For All Thick Melanomas

Maki Yamamoto MD Health Sciences Clinical Assistant Professor UC Irvine Health University of California, Irvine Orange, CA 92868MedicalResearch.com Interview with:
Maki Yamamoto MD
Health Sciences Clinical Assistant Professor
UC Irvine Health
University of California, Irvine
Orange, CA 92868

Medical Research: What is the background for this study? What are the main findings?

Dr. Yamamoto: The Multicenter Selective Lymphadenectomy Trial-I (MSLT-I), a large, prospective randomized trial, evaluated patients with clinically lymph node-negative melanoma who were undergoing sentinel lymph node biopsy (SLNB) or observation of their lymph node basins. The MSLT-I helped to form the basis for the recent recommendation in the ASCO-SSO joint guideline that SLNB is indicated for patients with intermediate-thickness melanoma (measuring 1-4mm). However, controversy remains regarding the use of SLNB in both patients with thin (measuring <1 mm) and thick (measuring>4mm) melanoma.

Medical Research: What should clinicians and patients take away from your report?

Dr. Yamamoto: Our study retrospectively studied 571 patients with thick cutaneous melanoma (>/=4mm) and their associated outcomes.  We found that we had an acceptably low false negative rate with SLNB in this group of patients and a negative sentinel node biopsy had a significantly prolonged overall, disease-specific and recurrence-free survival when compared to those with a positive biopsy.  Therefore, SLNB should be considered as indicated for patients with thick, clinically lymph node-negative melanoma.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Yamamoto: One of the next steps in future research could be to refine techniques to decrease the false negative rate for SLNB in melanoma or to elucidate why some patients may recur distally despite a negative SLNB.

Citation:

Sentinel lymph node biopsy is indicated for patients with thick clinically lymph node-negative melanoma

Yamamoto M1, Fisher KJ, Wong JY, Koscso JM, Konstantinovic MA, Govsyeyev N, Messina JL, Sarnaik AA, Cruse CW, Gonzalez RJ, Sondak VK, Zager JS.
Cancer. 2015 Feb 11. doi: 10.1002/cncr.29239. [Epub ahead of print]

 

MedicalResearch.com Interview with: Maki Yamamoto MD (2015). Sentinel Lymph Node Biopsy Should Be Considered For All Thick Melanomas 

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Last Updated on February 24, 2015 by Marie Benz MD FAAD