This guideline (full title: ‘The Current Role of Sentinel Lymph Node Biopsy in the Management of Cutaneous Melanoma – a UK Consensus Statement’) is the product of a meeting that took place in Cambridge in May 2018, organised by Melanoma Focus and chaired by Mr Howard Peach. It involved some 70 clinicians, nurses and patient representatives, who came together to consider issues surrounding sentinel lymph node biopsy and completion lymph node dissection. Three main areas were addressed: oncology, surgery and pathology.
The guideline has now been published in The Journal of Plastic, Reconstructive & Aesthetic Surgery (Volume 73, Issue 1, January 2020, Pages 36-42).
View the online article here.
Mr Howard Peach, a plastic surgeon at Leeds Teaching Hospitals NHS Trust and a Trustee of Melanoma Focus, who chaired the Consensus group, said:
With the changes in melanoma management that have taken place in recent years, it was time to re-visit the whole question of the role of sentinel node biopsy (SNB) in the treatment and prognosis of melanoma patients. We have drawn on key findings from a number of recent clinical trials in developing, for the first time, a formal set of recommendations for clinical practice in the UK.
‘The introduction of effective adjuvant therapy for melanoma has changed the primary role of SNB: from a prognostic indicator to one that now influences access to this form of therapy. Aligned with this change is the role of completion lymph node dissection (CLND) following a positive biopsy of the sentinel lymph nodes. Since defining the specific group of people who might benefit from this procedure has been difficult, CLND has routinely been recommended for all. However, the results of two large international trials – and the availability of drug therapy for patients who develop a recurrence – have changed international opinion. It was therefore agreed that CLND should NOT be recommended routinely for patients who have a positive SNB. We hope this evidence-based and considered guidance will help healthcare professionals when they advise patients on their treatment options’.
Melanoma Focus is grateful to the authors, who are listed at the end of the document, and all those who gave generously of their time in developing and reviewing the guideline.
Please email info@melanomafocus.org if you have any queries or comments.
With the help of Ms Jenny Geh and Mr Oliver Bloom, Guy’s and St Thomas’ NHS Trust, we have created two animated videos for your patients to help them understand the sentinel lymph node biopsy procedure and what happens on the day.
View the animation videos here.