New Zealand patients have higher melanoma burden in sentinel nodes and completion lymphadenectomy than patients in MSLT-II
May 30, 2023
Abstract
New Zealand has the highest rate of melanoma-related mortality in the world. Access to immunotherapy and radiology is limited and surgical treatment of regional disease remains important. A recent pilot study of a single health district observed a higher nodal melanoma burden than was reported in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II). In this study, a series of regional censuses were undertaken covering the 10 years immediately prior to the publication of MSLT-II. The study population was seven District Health Boards covering 62.2% of the population of New Zealand across a 10-year period preceding MSLT-II. The primary outcomes measured were size of sentinel lymph node metastases and non-sentinel node (NSN) positivity on completion lymph node dissection (CLND) for patients with a positive sentinel lymph node biopsy (SLNB). In the 2323 SLNB identified the mean sentinel lymph node metastatic deposit size was larger compared to MSLT-II (2.55 vs. 1.07/ 1.11 mm). A greater proportion of New Zealand patients (44.2%) had metastatic deposits larger than 1 mm compared to MSLT-II (33.2/34.5%) and the rate of non -sentinel node involvement on CLND was also higher (22.2% vs. 11.5%). These findings indicate that New Zealand is a high-risk population for nodal melanoma metastases. Due to these differences, the conclusions of MSLT-II may not be able to be applied to melanoma patients in the 7 regions studied in New Zealand.
Source:
Tea Stuart Williams, Jacob Arahill-Whitham, Teresa A Bailey, Greg Hayward, Alexandra Li, Ben Tallon, Daniel Wen and Brandon Michael Adams, New Zealand patients have higher melanoma burden in sentinel nodes and completion lymphadenectomy than patients in MSLT-II, Journal of Plastic, Reconstructive & Aesthetic Surgery, (2023)
doi:https://doi.org/10.1016/j.bjps...
https://www.jprasurg.com/artic...
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Note: This study is referenced in the article as reference 6:
Melanoma sentinel lymph node biopsy and completion lymph node dissection: A regional hospital experience - Journal of Plastic, Reconstructive & Aesthetic Surgery (jprasurg.com)