Lymph Node Test a Good Strategy for Melanoma: Study
Disease spread was detected and treated sooner, with better survival in patients who received 'sentinel node' biopsy
In melanoma, a sentinel node biopsy removes the lymph node nearest a lesion and tests it for evidence of cancer. If the sentinel node is unaffected, the cancer is highly unlikely to have spread to surrounding lymph nodes or distant sites in the body. The biopsy procedure is also used in other malignancies, particularly breast cancer.
In the new study's biopsy group, sentinel node results were the most important predictor for 10-year survival of melanoma among patients with lesions considered intermediate or thick.
Disease-free survival rates over 10 years were significantly better in the biopsy group among patients with intermediate melanoma (about 71 percent compared with 65 percent) and thick melanoma (nearly 51 percent versus about 41 percent).
Among patients whose cancer spread to the lymph nodes from an intermediate-thickness melanoma, biopsy yielded better 10-year disease-free survival to distant organs as well as better overall survival from melanoma.
Removing all lymph nodes from an area of the body can trigger painful, chronic tissue swelling known as lymphedema. But this risk for melanoma patients can be supported by the survival-rate improvements documented in the new study, said Dr. Charles Balch, a professor of surgery in the division of surgical oncology at University of Texas Southwestern Medical Center, in Dallas.
Balch, who co-wrote a journal editorial accompanying the study, called the research "practice-changing" because of the length of the clinical trial and the strength of the findings.
"If we know there's an increase for leg or arm swelling, we can justify [node removal] more to the patient if it increases survival," Balch said. "This is the largest study ever done on this subject, and it's multinational with the longest follow-up. It's really a seminal work."