Complete lymph node dissection versus no dissection in patients with sentinel lymph node biopsy positive melanoma (DeCOG-SLT): a multicentre, randomised, phase 3 trial

Melanoma Staging: American Joint Committee on Cancer (AJCC) 8th Edition and Beyond

“…21,22 It is worth noting that the 8th edition AJCC Cancer Staging Manual provides specific recommendations for documentation of the now common scenario when SLN biopsy identifies tumor-involved SLNs but CLND is not performed. 9 To distinguish patients who have had a CLND from those who have not, the ''(sn)'' suffix should be appended to the N category for those who did not undergo CLND-i.e., a patient with a single tumorinvolved SLN who does not undergo CLND is pN1a(sn).…”

Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline – Update 2016

“…Nonetheless when the SLND shows micrometastases, radical lymph node dissection was usually recommended as approximately 5e12% of patients will have involvement of non-sentinel nodes. A German prospective randomised trial on the value of CLND in patients with positive SLN did not show any survival benefit after a 3-year follow-up for patients undergoing CLND [86]. Similarly in a matched cohort study across multiple centres no impact of CLND on survival could be demonstrated [87].…”

Surgical Management of Melanoma

“…There is no consensus regarding the application or clinical implications of SLNB in patients whose melanomas are <1 mm in thickness, and indications continue to evolve (Table 2). Based on available evidence, high-risk patients with melanomas between 0.75 and 1.00 mm in thickness may be appropriate candidates to be considered for SLN biopsy; however, there is little rationale in performing SLNB on the overwhelming majority of patients with melanomas <0.75 mm in thickness (14).…”

“…Indications for performing SLNB is a balance between the likelihood of finding a positive SLN, the risk of the procedure, as well as the likely benefits that will accrue to the patient from the knowledge of their SLN status (14). It selects appropriate patients for completion lymph node dissection with potential for regional disease control.…”