publication date: Aug. 3, 2017

Melanoma

Delaying lymph node biopsy after diagnosis doesn’t affect survival

Postponing lymph node biopsy more than 30 days after melanoma diagnosis doesn’t adversely impact long-term clinical outcomes, according to new study findings published online as an “article in press” on the Journal of the American College of Surgeons website ahead of print publication.

In theory, postponing biopsy after a melanoma diagnosis could affect outcomes, either in a negative way by allowing the growth and spread of cancerous cells to lymph nodes, or in a positive way by allowing development of an anti-melanoma immune response.

In this study, the largest one to date, researchers analyzed the effect of delayed sentinel lymph node biopsy on survival of patients with melanoma.

Researchers from the John Wayne Cancer Institute and elsewhere examined the medical records of 2,483 patients who underwent wide local excision and sentinel lymph node biopsy for melanoma skin cancer between 1999 and 2015.

They analyzed whether lymph nodes biopsied later were associated with different outcomes, either positive or negative, compared to lymph nodes biopsied earlier. The average follow-up time was eight years.

Early and delayed sentinel-lymph node biopsy were defined as less than 30 days and more than 30 days from diagnosis, respectively. Primary outcomes included disease-free survival and melanoma-specific survival.

Of those 2,483 patients, positive sentinel lymph nodes were identified in 432 patients, 17 percent. A majority of patients, 58 percent, underwent early sentinel-lymph node biopsy. The study found no difference in melanoma-specific survival or disease-free survival in patients who underwent early or delayed sentinel lymph node biopsy. In other words, there was no harm or benefit in waiting 30 days or longer to have a lymph node biopsy.

An independent dataset from the first Multicenter Selective Lymphadenectomy Trial, a multicenter prospective randomized … Continue reading CCL July 2017 – Delaying lymph node biopsy after diagnosis doesn’t affect survival

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