Since 1990, the Department of Surgical Oncology of UMCG has participated in two large international studies on the importance of sentinel node biopsy in melanoma. These were the Multicenter Selective Lymphadenctomy Trials, the MSLT I and MSLT II. The other center participating in the Netherlands was the AVL in Amsterdam. The UMCG had a very large participation in the MSLT trials. An article was recently published online in JAMA Surgery.
The study shows that patients who have been shown to have metastases in their lymph nodes after a sentinel node biopsy do not benefit from additional surgery of their nodes. Instead, they can also be monitored regularly in the hospital. If their disease recurred, they can still be treated without the fact that they have not had complemented surgery affecting their prognosis and survival. This is an important conclusion for this group of patients. It saves them from having additional surgery and prevents them from being at risk for mobility disorders of the arm, leg or neck or abnormal accumulation of lymph fluid, edema, as a result of lymphnode dissection.
Attached is the link to the publication in JAMA Surgery: Therapeutic Value of Sentinel Lymph Node Biopsy in Patients With Melanoma: A Randomized Clinical Trial | Dermatology | JAMA Surgery | JAMA Network
Another study in the field of melanoma in which the UMCG played a prominent role is the so-called MELFO study. This was initiated in 2006 by the Department of Surgery at UMCG, the Wenckebach Institute and Comprehensive Cancer Center North-East. The study aimed to investigate the importance of proper counseling after the diagnosis of melanoma. In close cooperation, a similar study was conducted in England for several years. Earlier it was shown that there were no differences in the outcome of the studies in the Netherlands and England. In order to further increase the power of the study the two studies were merged and analyzed. The paper describing the results was recently published online in the Annals of Surgery. This is the leading surgical journal. The journal considered the paper a Landmark paper, meaning that it will be of great influence in the treatment of melanoma, in this case the follow-up after diagnosis.
The study shows that it is safe to monitor less intensively after treatment patients with melanoma who have been found to have no metastases after a sentinel node examination. The study shows that self-examination appears to be an effective way to detect a melanoma recurrence early. It is the first randomized study to examine the frequency of follow-up in patients with unmetastatic melanoma. Current recommendations for follow-up are based on consensus. Reduced frequency of checks is not associated with increased patient anxiety, later detection of melanoma recurrence, or poorer survival outcomes.
Attached is the link to the publication in Annals of Surgery : Follow-up Schedule for Patients with Sentinel Node Negative... : Annals of Surgery (lww.com)
The results of these two studies provide a further scientific basis that will lead to the treatment of melanoma becoming a little more personalized. The results will certainly be included in the national melanoma guideline.
