New guidelines issued for biopsy use in melanoma patients
Expert panel said sentinel lymph node biopsy to show if cancer has spread could be used more consistently.
(HealthDay) -- Sentinel lymph node biopsy -- a minimally invasive surgical technique that lets doctors see whether cancer has spread -- should be performed on patients with melanoma tumors of intermediate thickness and may also be appropriate for thick melanoma tumors, according to new guidelines released Monday.
The American Society of Clinical Oncology (ASCO) and the Society for Surgical Oncology issued the evidence-based recommendations to clarify the use of this type of biopsy, which they said has been inconsistent.
A sentinel lymph node is the first lymph node to which cancer cells are most likely to spread from the original tumor, according to the U.S. National Cancer Institute. There can be more than one sentinel lymph node. During a biopsy, the node is identified, removed and examined for cancer cells.
"When used for the right patients at the right time, sentinel lymph node biopsy is one of our best tools for personalizing melanoma treatment, and for sparing patients from unnecessary procedures or therapies," study lead author Dr. Sandra Wong, co-chair of the guideline panel and an assistant professor of surgery at the University of Michigan, said in an ASCO news release.
The panel of 14 clinical and methodological experts from various disciplines reviewed 73 studies, involving 25,000 patients, that were published over the past two decades. After examining this evidence, the panel made the following recommendations:
- The procedure is recommended for all patients with melanoma tumors between 1 millimeter (mm) and 4 mm (intermediate thickness). Sentinel lymph node biopsy detects cancer in the sentinel node in about 18 percent to 26 percent of these patients, the panel noted.
- Sentinel lymph node biopsy may be beneficial to patients with melanoma tumors greater than 4 mm ("thick"). The panel noted, however, that few studies focus on the use of the biopsy in patients with thick melanomas.
- The panel found there is not enough evidence to recommend routine sentinel lymph node biopsy for patients with melanoma tumors less than 1 mm ("thin"). The experts added that thin melanomas can usually be cured through surgical removal of the primary tumor. However, the biopsy could be considered in patients with thin melanoma who have certain high-risk factors, such as rapidly dividing cancer cells.
Patients with a positive sentinel lymph node biopsy should undergo complete removal of the remaining lymph nodes, the experts added. This procedure has been shown to prevent the spread of cancer.
The panel also advised doctors to discuss sentinel lymph node biopsy, particularly the procedure's potential risks and benefits, with their patients as part of the treatment-planning process.
"Our rapidly growing understanding of the biology of melanoma is driving development of more effective treatments with fewer side effects for patients," panel co-chair Dr. Gary Lyman, a professor of medicine and director of comparative effectiveness and outcomes research at Duke University School of Medicine and the Duke Cancer Institute, said in the news release.
"But to take advantage of this progress, we need to know the true extent of the disease from the start. This guideline will help ensure that sentinel lymph node biopsy is used appropriately whenever it can provide that vital information while avoiding unnecessary procedures in patients who are unlikely to benefit."
Information on the guidelines was published online by ASCO.
More information:
The U.S. National Cancer Institute has more about melanoma.
Copyright © 2012 HealthDay. All rights reserved.
-
Sentinel node biopsy safe, effective in head and neck melanomas
Aug 05, 2011 |
not rated yet |
0
-
Breast cancer patients with positive ultrasound guided axillary node biopsy need dissection
May 03, 2012 |
not rated yet |
0
-
Microbubble ultrasound and breast biopsies
Feb 01, 2011 |
not rated yet |
0
-
Largest-ever breast cancer surgery study published
Sep 22, 2010 |
not rated yet |
0
-
Rare skin tumor responds better to treatment than melanoma
Feb 02, 2009 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Why is zone 1 in liver more prone to ischemic injury?
21 hours ago
-
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013
-
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013
-
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013
-
If you became brain-dead, would you want them to pull the plug?
May 17, 2013
-
MRI bill question
May 15, 2013
- More from Physics Forums - Medical Sciences
More news stories
Research identifies a way to make cancer cells more responsive to chemotherapy
Breast cancer characterized as "triple negative" carries a poor prognosis, with limited treatment options. In some cases, chemotherapy doesn't kill the cancer cells the way it's supposed to. New research from Western University ...
Cancer
8 hours ago |
5 / 5 (2) |
0
Mayo Clinic genomic analysis lends insight to prostate cancer
Mayo Clinic researchers have used next generation genomic analysis to determine that some of the more aggressive prostate cancer tumors have similar genetic origins, which may help in predicting cancer progression. The findings ...
Cancer
8 hours ago |
not rated yet |
0
When oxygen is short, EGFR prevents maturation of cancer-fighting miRNAs
Even while being dragged to its destruction inside a cell, a cancer-promoting growth factor receptor fires away, sending signals that thwart the development of tumor-suppressing microRNAs (miRNAs) before it's dissolved, researchers ...
Cancer
9 hours ago |
not rated yet |
0
|
Improved chemo regimen for childhood leukemia may offer high survival, no added heart toxicity
Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at a more intense-than-standard dose during initial treatment may result in high survival rates without causing any added ...
Cancer
13 hours ago |
not rated yet |
0
Protein preps cells to survive stress of cancer growth and chemotherapy
Scientists have uncovered a survival mechanism that occurs in breast cells that have just turned premalignant-cells on the cusp between normalcy and cancers-which may lead to new methods of stopping tumors.
Cancer
14 hours ago |
not rated yet |
0
|
Controlling mood through the motions of mitochondria
(Medical Xpress)—Regulating the distribution of power in neurons is done by a system that makes the national electric grid look simple by comparison. Each neuron has several thousand mitochondria confined ...
Motion quotient: IQ predicted by ability to filter motion (w/ video)
A brief visual task can predict IQ, according to a new study. This surprisingly simple exercise measures the brain's unconscious ability to filter out visual movement. The study shows that individuals whose ...
Multiple research teams unable to confirm high-profile Alzheimer's study
Teams of highly respected Alzheimer's researchers failed to replicate what appeared to be breakthrough results for the treatment of this brain disease when they were published last year in the journal Science.
Scientists discover molecule triggers sensation of itch
Scientists at the National Institutes of Health report they have discovered in mouse studies that a small molecule released in the spinal cord triggers a process that is later experienced in the brain as ...
Researchers find common childhood asthma unconnected to allergens or inflammation
Little is known about why asthma develops, how it constricts the airway or why response to treatments varies between patients. Now, a team of researchers at Weill Cornell Medical College, Columbia University Medical Center ...
ACP issues recommendations for management of high blood glucose in hospitalized patients
High blood glucose is associated with poor outcomes in hospitalized patients, and use of intensive insulin therapy (IIT) to control hyperglycemia is a common practice in hospitals. But the recent evidence does not show a ...