Management of metastases in regional lymph nodes in melanoma patients in 2019

Abstract

For several years, the standard of management in case of melanoma metastases in regional lymph nodes was to remove an adequate node group. In 2016 and 2017, the results of two large, well-designed clinical trials with randomization and a control group were published, which changed the current management. The authors of DeCOG-STL study came to the conclusion that withdrawal from completion lymph node dissection in the case of a small melanoma metastasis in a sentinel lymph node (metastasis diameter ≤1 mm) is not associated with a worsening of the 3-years’ survival chance (both in terms of overall survival and survival time to the occurrence of distant metastases). The results of MSTL-II study were similar. Based on the results of both studies presented above, in 2018 the American Society of Clinical Oncology (ASCO) and the Society of Surgical Oncology (SSO) presented joint recommendations concerning, among others, current indications for completion lymph node dissection in SNB positive melanoma patients.