Therapeutic value of sentinel lymph node biopsy in patients with melanoma

The second Multicenter Selective Lymphadenectomy Trial (MSLT-II) randomized patients with sentinal lymph node (SLN) metastases from cutaneous melanoma after SLN biopsy to either completion lymph node dissection (CLND) or observation. The primary analysis, published in 2017, showed that immediate CLND increased the rate of regional disease control. Analysis of patients in the observation arm now shows that SLN biopsy without CLND cleared disease in the affected nodal basin in most patients, resulting in freedom from regional nodal recurrence in 80.2% of observed basins at 10 years. The authors conclude that SLN biopsy may be regarded as therapeutic in some patients.