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Final Trial Report of Sentinel-Node Biopsy versus Nodal Observation in Melanoma
Ist Teil von
The New England journal of medicine, 2014-02, Vol.370 (7), p.599-609
Ort / Verlag
Waltham, MA: Massachusetts Medical Society
Erscheinungsjahr
2014
Quelle
Free E-Journal (出版社公開部分のみ)
Beschreibungen/Notizen
Sentinel-node biopsy followed by lymphadenectomy for tumor-positive nodes improved disease-free survival among patients with intermediate-thickness melanomas (1.2 to 3.5 mm) and those with thick melanomas (>3.5 mm).
Regional node management in melanoma has remained controversial since Snow
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recommended elective complete lymphadenectomy for all patients with melanoma, regardless of whether there was clinical evidence of regional nodal metastases. However, routine elective lymphadenectomy exposes all patients to procedure-related complications and cannot benefit the majority, who have no regional nodal metastases. Multiple randomized trials have suggested a benefit of routine lymphadenectomy in at least some groups of patients with melanoma.
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Because of dissatisfaction with both elective lymphadenectomy and nodal observation, lymphatic mapping and sentinel-node biopsy were introduced for individualized management of regional lymph nodes.
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Sentinel-node biopsy is a . . .