Complications after surgery for malignant melanoma do not delay further treatment

Munkhammar, Sara; Sars, Carl; Schultz, Inkeri; Gillgren, Peter; Lindqvist, Ebba K.

doi:10.1007/s00238-021-01839-9

Cited by 1 publication

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“…The results of these landmark studies have changed clinical practice, and CLND is no longer the standard of treatment in all melanoma patients with involved lymph nodes without distant metastases (stage III). These changes coincided with the increasingly important role of adjuvant systemic therapy in this group and an introduction of a wide pool of novel regimens [10][11][12][13]. Currently, the most common regimens of adjuvant therapy are based on a combination of dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor) in patients with BRAF V600 mutation, as well as nivolumab or pembrolizumab (targeting programmed death receptor 1) in melanoma patients with or without BRAF V600 mutation [14][15][16][17][18][19].…”

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confidence: 99%

The Current Treatment Trends and Survival Patterns in Melanoma Patients with Positive Sentinel Lymph Node Biopsy (SLNB): A Multicenter Nationwide Study

Ziętek

Teterycz

Wierzbicki

et al. 2023

Cancers

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Background: In melanoma treatment, an approach following positive sentinel lymph node biopsy (SLNB) has been recently deescalated from completion lymph node dissection (CLND) to active surveillance based on phase III trials data. In this study, we aim to evaluate treatment strategies in SLNB-positive melanoma patients in real-world practice. Methods: Five-hundred-fifty-seven melanoma SLNB-positive patients from seven comprehensive cancer centers treated between 2017 and 2021 were included. Kaplan–Meier methods and the Cox Proportional-Hazards Model were used for analysis. Results: The median follow-up was 25 months. Between 2017 and 2021, the percentage of patients undergoing CLND decreased (88–41%), while the use of adjuvant treatment increased (11–51%). The 3-year OS and RFS rates were 77.9% and 59.6%, respectively. Adjuvant therapy prolonged RFS (HR:0.69, p = 0.036)), but CLND did not (HR:1.22, p = 0.272). There were no statistically significant differences in OS for either adjuvant systemic treatment or CLND. Lower progression risk was also found, and time-dependent hazard ratios estimation in patients treated with systemic adjuvant therapy was confirmed (HR:0.20, p = 0.002 for BRAF inhibitors and HR:0.50, p = 0.015 for anti-PD-1 inhibitors). Conclusions: Treatment of SLNB-positive melanoma patients is constantly evolving, and the role of surgery is currently rather limited. Whether CLND has been performed or not, in a group of SLNB-positive patients, adjuvant systemic treatment should be offered to all eligible patients.

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