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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2012

01-10-2012 | SSO Special Article

Sentinel Lymph Node Biopsy for Melanoma: American Society of Clinical Oncology and Society of Surgical Oncology Joint Clinical Practice Guideline

Authors: Sandra L. Wong, Charles M. Balch, Patricia Hurley, Sanjiv S. Agarwala, Timothy J. Akhurst, Alistair Cochran, Janice N. Cormier, Mark Gorman, Theodore Y. Kim, Kelly M. McMasters, R. Dirk Noyes, Lynn M. Schuchter, Matias E. Valsecchi, Donald L. Weaver, Gary H. Lyman

Published in: Annals of Surgical Oncology | Issue 11/2012

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Abstract

Purpose

The American Society of Clinical Oncology (ASCO) and Society of Surgical Oncology (SSO) sought to provide an evidence-based guideline on the use of lymphatic mapping and sentinel lymph node (SLN) biopsy in staging patients with newly diagnosed melanoma.

Methods

A comprehensive systematic review of the literature published from January 1990 through August 2011 was completed using MEDLINE and EMBASE. Abstracts from ASCO and SSO annual meetings were included in the evidence review. An Expert Panel was convened to review the evidence and develop guideline recommendations.

Results

Seventy-three studies met full eligibility criteria. The evidence review demonstrated that SLN biopsy is an acceptable method for lymph node staging of most patients with newly diagnosed melanoma.

Recommendations

SLN biopsy is recommended for patients with intermediate-thickness melanomas (Breslow thickness, 1–4 mm) of any anatomic site; use of SLN biopsy in this population provides accurate staging. Although there are few studies focusing on patients with thick melanomas (T4; Breslow thickness, >4 mm), SLN biopsy may be recommended for staging purposes and to facilitate regional disease control. There is insufficient evidence to support routine SLN biopsy for patients with thin melanomas (T1; Breslow thickness, <1 mm), although it may be considered in selected patients with high-risk features when staging benefits outweigh risks of the procedure. Completion lymph node dissection (CLND) is recommended for all patients with a positive SLN biopsy and achieves good regional disease control. Whether CLND after a positive SLN biopsy improves survival is the subject of the ongoing Multicenter Selective Lymphadenectomy Trial II.
Copyright © 2012 American Society of Clinical Oncology and Society of Surgical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by the American Society of Clinical Oncology and Society of Surgical Oncology.
Appendix
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Literature
1.
Balch CM, Gershenwald JE, Soong SJ, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27:6199–206PubMedCrossRef
2.
Balch CM, Gershenwald JE, Soong SJ, et al. Multivariate analysis of prognostic factors among 2,313 patients with stage III melanoma: comparison of nodal micrometastases versus macrometastases. J Clin Oncol. 2010;28:2452–9PubMedCrossRef
3.
Balch CM, Morton DL, Gershenwald JE, et al. Sentinel node biopsy and standard of care for melanoma. J Am Acad Dermatol. 2009;60:872–5PubMedCrossRef
4.
Valsecchi ME, Silbermins D, de Rosa N, et al. Lymphatic mapping and sentinel lymph node biopsy in patients with melanoma: a meta-analysis. J Clin Oncol. 2011;29:1479–87PubMedCrossRef
5.
Morton DL, Thompson JF, Cochran AJ, et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med. 2006;355:1307–17PubMedCrossRef
6.
Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6PubMedCrossRef
7.
Gershenwald JE, Thompson W, Mansfield PF, et al. Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients. J Clin Oncol. 1999;17:976–83PubMed
8.
Reintgen D, Cruse CW, Wells K, et al. The orderly progression of melanoma nodal metastases. Ann Surg. 1994;220:759–67PubMedCrossRef
9.
Thompson JF, McCarthy WH, Bosch CM, et al. Sentinel lymph node status as an indicator of the presence of metastatic melanoma in regional lymph nodes. Melanoma Res. 1995;5:255–60PubMedCrossRef
10.
Uren RF, Howman-Giles R, Thompson JF, et al. Lymphoscintigraphy to identify sentinel lymph nodes in patients with melanoma. Melanoma Res. 1994;4:395–9PubMedCrossRef
11.
Wrightson WR, Wong SL, Edwards MJ, et al. Complications associated with sentinel lymph node biopsy for melanoma. Ann Surg Oncol. 2003;10:676–80PubMedCrossRef
12.
McMasters KM, Noyes RD, Reintgen DS, et al. Lessons learned from the Sunbelt Melanoma Trial. J Surg Oncol. 2004;86:212–23PubMedCrossRef
13.
Sondak VK, Taylor JM, Sabel MS, et al. Mitotic rate and younger age are predictors of sentinel lymph node positivity: lessons learned from the generation of a probabilistic model. Ann Surg Oncol. 2004;11:247–58PubMedCrossRef
14.
Sabel MS, Rice JD, Griffith KA, et al. Validation of statistical predictive models meant to select melanoma patients for sentinel lymph node biopsy. Ann Surg Oncol. 2012;19:287–93PubMedCrossRef
15.
Edge SB, Byrd DR, Compton CC, et al. (eds): AJCC cancer staging manual. 7th edn. New York, NY: Springer
16.
Morton DL, Cochran AJ, Thompson JF, et al. Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg. 2005;242:302–11; discussion 311–3PubMed
17.
Eggermont AM, Suciu S, Santinami M, et al. Adjuvant therapy with pegylated interferon alfa-2b versus observation alone in resected stage III melanoma: final results of EORTC 18991, a randomised phase III trial. Lancet. 2008;372:117–26PubMedCrossRef
18.
Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol. 2001;19:3635–48PubMed
19.
Balch CM, Soong SJ, Gershenwald JE, et al. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol 2001;19:3622–34PubMed
20.
Gershenwald JE, Mansfield PF, Lee JE, et al. Role for lymphatic mapping and sentinel lymph node biopsy in patients with thick (≥4 mm) primary melanoma. Ann Surg Oncol. 2000;7:160–5PubMedCrossRef
21.
Ferrone CR, Panageas KS, Busam K, et al. Multivariate prognostic model for patients with thick cutaneous melanoma: importance of sentinel lymph node status. Ann Surg Oncol. 2002;9:637–45PubMedCrossRef
22.
Balch CM, Gershenwald JE, Soong SJ, et al. Update on the melanoma staging system: the importance of sentinel node staging and primary tumor mitotic rate. J Surg Oncol. 2011;104:379–385PubMed
23.
Gajdos C, Griffith KA, Wong SL, et al. Is there a benefit to sentinel lymph node biopsy in patients with T4 melanoma? Cancer 2009;115:5752–60PubMedCrossRef
24.
Essner R, Chung MH, Bleicher R, et al. Prognostic implications of thick (≥4 mm) melanoma in the era of intraoperative lymphatic mapping and sentinel lymphadenectomy. Ann Surg Oncol. 2002;9:754–61PubMed
25.
Carlson GW, Murray DR, Hestley A, et al. Sentinel lymph node mapping for thick (≥4 mm) melanoma: should we be doing it? Ann Surg Oncol. 2003;10:408–15PubMedCrossRef
26.
Thompson JF, Shaw HM. The prognosis of patients with thick primary melanomas: is regional lymph node status relevant, and does removing positive regional nodes influence outcome? Ann Surg Oncol. 2002;9:719–22PubMedCrossRef
27.
Gutzmer R, Satzger I, Thoms KM, et al. Sentinel lymph node status is the most important prognostic factor for thick (≥4 mm) melanomas. J Dtsch Dermatol Ges. 2008;6:198–203PubMedCrossRef
28.
Scoggins CR, Bowen AL, Martin RC 2nd, et al. Prognostic information from sentinel lymph node biopsy in patients with thick melanoma. Arch Surg. 2010;145:622–7PubMedCrossRef
29.
Criscione VD, Weinstock MA. melanoma thickness trends in the United States, 1988-2006. J Invest Dermatol. 2010;130:793–7PubMedCrossRef
30.
Andtbacka RH, Gershenwald JE. Role of sentinel lymph node biopsy in patients with thin melanoma. J Natl Compr Canc Netw. 2009;7:308–17PubMed
31.
Amersi F, Morton DL. The role of sentinel lymph node biopsy in the management of melanoma. Adv Surg. 2007;41:241–56PubMedCrossRef
32.
Wong SL, Morton DL, Thompson JF, et al. Melanoma patients with positive sentinel nodes who did not undergo completion lymphadenectomy: a multi-institutional study. Ann Surg Oncol. 2006;13:809–16PubMedCrossRef
33.
Kingham TP, Panageas KS, Ariyan CE, et al. Outcome of patients with a positive sentinel lymph node who do not undergo completion lymphadenectomy. Ann Surg Oncol. 2010;17:514–20PubMedCrossRef
34.
Calabro A, Singletary SE, Balch CM. Patterns of relapse in 1,001 consecutive patients with melanoma nodal metastases. Arch Surg. 1989;124:1051–5PubMedCrossRef
35.
Wong SL, Brady MS, Busam KJ, et al. Results of sentinel lymph node biopsy in patients with thin melanoma. Ann Surg Oncol. 2006;13:302–9PubMedCrossRef
36.
Geller AC, Miller DR, Lew RA, et al. Cutaneous melanoma mortality among the socioeconomically disadvantaged in Massachusetts. Am J Public Health. 1996;86:538–43PubMedCrossRef
37.
Chang AE, Karnell LH, Menck HR: The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade–The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998;83:1664–78PubMedCrossRef
Metadata
Title
Sentinel Lymph Node Biopsy for Melanoma: American Society of Clinical Oncology and Society of Surgical Oncology Joint Clinical Practice Guideline
Authors
Sandra L. Wong
Charles M. Balch
Patricia Hurley
Sanjiv S. Agarwala
Timothy J. Akhurst
Alistair Cochran
Janice N. Cormier
Mark Gorman
Theodore Y. Kim
Kelly M. McMasters
R. Dirk Noyes
Lynn M. Schuchter
Matias E. Valsecchi
Donald L. Weaver
Gary H. Lyman
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2475-3

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