Resource utilization & treatment options in SN+ve melanoma patients
Research type
Research Study
Full title
Evaluation of resource utilization and clinical outcomes in patients with cutaneous melanoma and sentinel lymph node positivity since publication of the MSLT-2 trial
IRAS ID
274893
Contact name
Marc Moncrieff
Contact email
Sponsor organisation
Norfolk & Norwich University Hopsital
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary
Management of patients with cutaneous melanoma and involved sentinel lymph nodes has changed dramatically in the past five years, based largely on the results from the MSLT-2 study and numerous recent clinical trials of adjuvant systemic therapy. Despite these recent, dramatic advances, several areas of uncertainty exist:
1. There are limited data to support the prescribed surveillance strategy, which was established by expert consensus;
2. Outcomes outside the trial setting have not been reported; and
3. The application of adjuvant systemic therapy to patients who do not undergo completion node dissection has not been well studied. We aim to address these items by compiling the collective experience of an international melanoma consortium.Summary of Results
For patients with melanoma of the skin and microscopic spread to lymph nodes, monitoring with ultrasound is an alternative to surgically removing the remaining lymph nodes. The authors studied adoption and real-world outcomes of ultrasound monitoring in over 1000 patients treated at 21 centres worldwide (including the UK), finding that most patients now have ultrasounds instead of surgery. Although slightly more patients have cancer return in the lymph nodes with this strategy, typically, it can be removed with delayed surgery. Compared with up-front surgery, ultrasound monitoring results in the same overall risk of melanoma coming back at any location or of dying from melanoma.
REC name
West of Scotland REC 1
REC reference
20/WS/0016
Date of REC Opinion
21 Jan 2020
REC opinion
Favourable Opinion