Sentinel Lymph Node Biopsy versus Nodal Observation in Melanoma

Despite a lack of treatment-related survival benefit, SLNB protected against microscopic nodal recurrence, and survival among patients with such disease was significantly better.

Sentinel lymph node biopsy (SLNB) is now a mainstay of prognostication, but its therapeutic benefit is controversial. In 1994, the Multicenter Selective Lymphadenectomy Trial (MSLT-I) was initiated to determine whether the procedure itself improved overall survival. The 5-year interval report noted no overall survival benefit, but the overall proportion of patients with positive lymph node disease was lower than anticipated. The final report of the MSLT-I trial has now been released.

At 10 years, there was no statistical between-group differences in treatment-related survival among patients with intermediate or thick cutaneous melanomas randomly assigned to nodal observation (wide excision and nodal observation with lymphadenectomy for nodal…

Reviewing Author

Hensin Tsao, MD, PhD

Disclosures

Consultant / advisory board Lubax; WorldCare Clinical

EquityLubax

Grant / Research support NIH; Department of Defense; American Skin Association; Piramal

Editorial boardsBritish Journal of Dermatology; Journal of the American Academy of Dermatology; Journal of Investigative Dermatology

Leadership positions in professional societies American Academy of Dermatology (Chair, Skin Cancer and Melanoma Committee); American Board of Dermatology (Director)