Management of Regional Nodal Melanoma

Christina V Angeles; Sandra L Wong

doi:10.1016/j.soc.2020.02.007

Management of Regional Nodal Melanoma

Surg Oncol Clin N Am. 2020 Jul;29(3):415-431. doi: 10.1016/j.soc.2020.02.007.

Authors

Christina V Angeles¹, Sandra L Wong²

Affiliations

¹ Department of Surgery, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
² Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03766, USA. Electronic address: sandra.l.wong@hitchcock.org.

PMID: 32482317
DOI: 10.1016/j.soc.2020.02.007

Abstract

Regional nodal melanoma management has changed substantially over the past 2 decades alongside advances in systemic therapy. Significant data from retrospective studies and from 2 randomized controlled trials show no survival benefit to completion lymph node dissection compared with observation in sentinel lymph node-positive melanoma patients. Observation is becoming the standard recommendation in these patients, whereas patients with clinically detected lymph nodes are still recommended to undergo lymph node dissection. Promising early results from a neoadjuvant approach inform the ongoing evolution of melanoma management. Recruiting patients to clinical trials is paramount to attaining evidence-based practice changes in melanoma.

Keywords: Locoregional disease; Lymph nodes; Lymphadenectomy; Melanoma; Multidisciplinary care; Neoadjuvant/adjuvant therapy; Nodal observation.

Publication types

Review

MeSH terms

Disease Management
Humans
Lymph Nodes / pathology
Lymph Nodes / surgery*
Melanoma / pathology
Melanoma / surgery*
Skin Neoplasms / pathology
Skin Neoplasms / surgery*