2013
DOI: 10.1097/cco.0b013e32835dafb4
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Completion lymph node dissection after a positive sentinel node

Abstract: Consensus on the sentinel node pathology work-up and analysis protocols are crucial for correct risk stratification and for clinical decision-making. Primary and sentinel node tumor burden parameters and patient comorbidities should be taken into consideration when offering CLND to an individual patient. In the future, prospective studies such as the MSLT-II and the EORTC 1208 (Minitub) will provide answers to whether CLND has a therapeutic benefit and to which patients might safely be spared CLND.

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Cited by 25 publications
(10 citation statements)
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“…Our study spanned 2000–2010 and 98.5% of our patients with a positive SLN underwent a CLND. Since this time the debate about whether CLND is indicated for all patients with positive SLN in melanoma has increased . It may be that patients with larger volume micrometastatic disease, which is more likely seen on FS, are the subset that benefit most from completion lymphadenectomy but this remains unproven.…”
Section: Discussionmentioning
confidence: 99%
“…Our study spanned 2000–2010 and 98.5% of our patients with a positive SLN underwent a CLND. Since this time the debate about whether CLND is indicated for all patients with positive SLN in melanoma has increased . It may be that patients with larger volume micrometastatic disease, which is more likely seen on FS, are the subset that benefit most from completion lymphadenectomy but this remains unproven.…”
Section: Discussionmentioning
confidence: 99%
“…To date several studies like MSLT-2 and the EORTC 1208 (Minitub) are being performed to investigate whether CLND can be spared in these patients [36,37].…”
Section: Discussionmentioning
confidence: 99%
“…[6][7][8][9][10][11] It has been proposed that patients with very small SN metastases (\0.1 mm diameter) have a favorable outcome and may not need completion lymphadenectomy. [12][13][14] Others have not been able to confirm these claims 10,15 which are, in any case, weakened by the fact that follow-up in the reported studies was initially short and that, predictably, recurrences and deaths have accumulated in this 'favorable' group as follow-up periods have increased. Coupled with this dilemma are concerns about the extent of nodal sampling required to accurately determine that NSNs are truly metastasis-free.…”
mentioning
confidence: 90%