Using so-called “sentinel node” biopsies to determine if melanoma has started
to spread saves some patients the pain of having all their lymph nodes removed,
U.S. researchers report.
The strategy can also give patients a
jump-start on aggressive treatment, they addrf.
There are few treatment options for
melanoma unless the disease is caught early. As a result, melanoma is one of the
deadliest cancers around.
However, patients whose lymph nodes tested
positive for cancer, and who had all their lymph nodes removed, had a much
higher five-year survival rate compared to those who tested positive but delayed
These results should help make sentinel
node biopsy standard practice in dealing with this type of malignancy, said lead
researcher Dr. Donald L. Morton, medical director and chief of the melanoma
program at John Wayne Cancer Institute at Saint Johns Hospital in Santa Monica,
His team published its findings in the
Sept. 28 issue of the New England Journal of
“People had been skeptical that sentinel
node biopsy was necessary. This further cements the view that it is,” said Dr.
Vijay Trisal, an assistant professor of surgical oncology at City of Hope Cancer
Center in Duarte, Calif. “This gives us an idea about the biology of the cancer,
and gives us ammunition that this is the right thing to
The findings are “not earth-shattering in
the sense of treatment, but certainly in terms of prediction,” commented Dr.
Donald McCain, a surgical oncologist and member of the melanoma division at
Hackensack University Medical Center Cancer Center, in Hackensack,
Melanoma is the most rapidly increasing
malignancy in the world today. According to the American Cancer Society, nearly
60,000 Americans will be diagnosed with melanoma this year, and almost 8,000
will die from the disease.
About 20 percent of patients with melanomas
of intermediate thickness have a microscopic spread of their cancer to the lymph
nodes — meaning the metastasis can’t be seen or felt. Generally speaking,
melanoma that spreads to the lymph nodes has a much poorer
Still, physicians haven’t been sure how to
approach the issue. Experts have tended to split into two camps: one
recommending that all lymph nodes automatically be removed, and the other
advocating waiting until the mass can actually be felt in the lymph