The sentinel node biopsy (SNB) surgical procedure has been used in the staging of melanoma patients for the many years. However, in the light of fundamental changes in the management of melanoma and the findings of recent clinical trials, it had become clear that there needed to be scrutiny of the role of SNB in patient prognosis and treatment, as well as the benefits or otherwise of completion lymph node dissection (CLND) following a positive biopsy of sentinel lymph nodes.
A group of clinicians, nurses and patient representatives met at the Melanoma Focus office in Cambridge in 2018 to debate the issues and reach a consensus on SNB and related issues. Their report was released later in the year, summarised by 11 recommendations in the form of a Consensus Statement.
The guideline has now been published in The Journal of Plastic, Reconstructive & Aesthetic Surgery (Volume 73, Issue 1, January 2020, Pages 36-42). Follow this link for the online article or this link for the PDF version.
On CLND, the group said this ‘should not be recommended routinely for patients who have a positive sentinel node biopsy. Patients deemed at high risk should be considered for adjuvant therapy. A lymph node dissection should be considered for those patients who subsequently present with node ONLY recurrence having failed first line systemic treatment’.
Follow this link to see further details and download the guideline document.