Multi-Center Melanoma Study Published in the New England Journal of Medicine
March 01, 2014
In the largest study of its kind, researchers have confirmed that a strategy to assess the spread of melanoma – pioneered by scientists at the John Wayne Cancer Institute – saves lives and spares some patients from troubling surgical side effects.
The study, called the Multicenter Selective Lymphadenectomy Trial (MSLT-I), was led by the late Donald L. Morton, MD, and co-authored by his colleagues at the Institute and around the world, including Mark B. Faries, MD, director of the Donald L. Morton, MD, Melanoma Research Program at the John Wayne Cancer Institute. The study validated the use of sentinel node biopsy, the revolutionary procedure developed by Dr. Morton more than 30 years ago.
Dr. Morton suggested that the spread of melanoma could be determined by examining the lymph node closest to the original tumor. Traditionally, doctors removed all of the lymph nodes in the area of the primary tumor to thwart the spread of cancer. However, this extensive surgery increases the risk of pain, infection and long-term swelling.
Dr. Morton suggested, however, that removing only the lymph node closest to the tumor, dubbed the sentinel node, provided an accurate assessment of how the cancer might spread without having to examine additional nodes. Sentinel node biopsy has been widely embraced and now applies to other cancers, such as breast cancer.
The new study, released in February in the prestigious New England Journal of Medicine, confirms the long-term value of sentinel node biopsy for patients with melanoma. It found that early removal and analysis of the sentinel node at the time of surgery decreased the chances of the melanoma recurring.
After 10 years, among patients who underwent sentinel node biopsy, 71.3% were still free of cancer compared to 64.7% in patients who did not have sentinel node biopsy. For patients with melanoma in their lymph nodes, early treatment using the biopsy technique increased survival by 44%.
The new study should ensure that melanoma patients receive evidence-based sentinel node biopsy as part of the disease assessment. “This publication is the culmination of nearly 20 years of research carried out worldwide,” says Dr. Faries. “We now have the best evidence yet that the sentinel node procedure not only gives patients the most accurate information about their future, it also increases their chances for survival.”