Lymphatic mapping, SLNB prolong survival for certain melanoma patients

Performing sentinel lymph node biopsies on melanoma patients can significantly prolong a patient’s disease-free life by early detection of metastasis, according to a recent study.

The study, conducted by researchers in the United States, Italy, Canada and Australia, compared the long-term results of sentinel lymph node biopsies (SLNB) and the “watch and wait” technique.

“This affirms a new standard for detecting melanoma metastasis to the lymph nodes by allowing doctors to quickly determine which patients actually have nodal metastasis and may benefit from having their nonsentinel lymph nodes removed (approximately 20 percent of patients), while sparing the surgery and its associated complications and substantial cost for the many patients who it cannot benefit (approximately 80 percent of patients),” according to a news release.

The effectiveness of these treatments in managing metastases was related to the thickness of the initial melanoma tumor.

The study found:

Patients with primary melanoma tumors of intermediate thickness (1.20 to 3.5 mm) who had sentinel lymph node biopsies with immediate complete removal of the lymph nodes if the sentinel node contained cancer cells had an overall disease-free survival of 71.3 percent compared to 64.7 percent for those whose nodes were observed without sentinel biopsy.

Sentinel node biopsy prolonged distant disease-free survival and melanoma-specific survival for patients with lymph node metastasis from primary melanomas of intermediate thickness.

“Although some patients with thick primary tumors benefit from having their lymph nodes removed, the findings suggest that the timing of the intervention is not as crucial for them as it is for patients with intermediate thickness primary tumors,” according to the news release. “Not enough patients with thin melanomas were in this trial to permit conclusions on their benefit from the technique, thus the effect of lymphatic mapping and sentinel-node biopsy in managing patients with thin primary melanomas remains for later study.”

The findings were published online Feb. 13 in the New England Journal of Medicine.