New guidelines issued for biopsy use in melanoma patients

July 9, 2012
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 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 are most likely to spread from the original tumor, according to the U.S. . 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 at the right time, is one of our best tools for personalizing 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 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 , 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 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.

Explore further: Sentinel node biopsy safe, effective in head and neck melanomas

More information:
The U.S. National Cancer Institute has more about melanoma.


Related Stories

Sentinel node biopsy safe, effective in head and neck melanomas

August 5, 2011
A common technique for determining whether melanoma has spread can be used safely and effectively even in tumors from the head and neck area, according to a new study from the University of Michigan Comprehensive Cancer Center.

Breast cancer patients with positive ultrasound guided axillary node biopsy need dissection

May 3, 2012
Contrary to a trend in treatment, breast cancer patients with suspicious lymph nodes should have an ultrasound-guided axillary node biopsy, and if that biopsy is positive these patients should undergo an axillary dissection, ...

Sentinel lymph node biopsy predicts outcomes for Merkel cell carcinoma

October 3, 2011
Patients with Merkel Cell Carcinoma who underwent a procedure called sentinel lymph node biopsy (SNLB) had a lower risk of cancer recurrence after two years, according to a study by researchers from Fox Chase Cancer Center. ...

Recommended for you

CAR-T immunotherapy may help blood cancer patients who don't respond to standard treatments

October 20, 2017
Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis is one of the first centers nationwide to offer a new immunotherapy that targets certain blood cancers. Newly approved ...

Researchers pinpoint causes for spike in breast cancer genetic testing

October 20, 2017
A sharp rise in the number of women seeking BRCA genetic testing to evaluate their risk of developing breast cancer was driven by multiple factors, including celebrity endorsement, according to researchers at the University ...

Study shows how nerves drive prostate cancer

October 19, 2017
In a study in today's issue of Science, researchers at Albert Einstein College of Medicine, part of Montefiore Medicine, report that certain nerves sustain prostate cancer growth by triggering a switch that causes tumor vessels ...

Suicide molecules kill any cancer cell

October 19, 2017
Small RNA molecules originally developed as a tool to study gene function trigger a mechanism hidden in every cell that forces the cell to commit suicide, reports a new Northwestern Medicine study, the first to identify molecules ...

Fundamental research enhances understanding of major cancer gene

October 19, 2017
New research represents a promising step towards better understanding of a key cancer gene. A long-running collaboration between researchers at the Babraham Institute, Cambridge and the AstraZeneca IMED Biotech Unit reveals ...

Gene circuit switches on inside cancer cells, triggers immune attack

October 19, 2017
Researchers at MIT have developed a synthetic gene circuit that triggers the body's immune system to attack cancers when it detects signs of the disease.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.