Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma.

M.B. Faries; J.F. Thompson; A.J. Cochran; R.H. Andtbacka; N. Mozzillo; J.S. Zager; T. Jahkola; T.L. Bowles; A. Testori; P.D. Beitsch; H.J. Hoekstra; M. Moncrieff; C. Ingvar; MWJM Wouters; M.S. Sabel; E.A. Levine; D. Agnese; M. Henderson; R. Dummer; C.R. Rossi; R.I. Neves; S.D. Trocha; F. Wright; D.R. Byrd; M. Matter; E. Hsueh; A. MacKenzie-Ross; D.B. Johnson; P. Terheyden; A.C. Berger; T.L. Huston; J.D. Wayne; B.M. Smithers; H.B. Neuman; S. Schneebaum; J.E. Gershenwald; C.E. Ariyan; D.C. Desai; L. Jacobs; K.M. McMasters; A. Gesierich; P. Hersey; S.D. Bines; J.M. Kane; R.J. Barth; G. McKinnon; J.M. Farma; E. Schultz; S. Vidal-Sicart; R.A. Hoefer; J.M. Lewis; R. Scheri; M.C. Kelley; O.E. Nieweg; R.D. Noyes; DSB Hoon; H.J. Wang; D.A. Elashoff; R.M. Elashoff

Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma.

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Date

8 juin 2017

Type de document

Articles

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Publications

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Anglais

Identifiants

doi: 10.1056/NEJMoa1613210
issn: 0028-4793

Source

Serveur académique Lausannois

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Ce document est lié à :
info:eu-repo/semantics/altIdentifier/doi/10.1056/NEJMoa1613210

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/pmid/28591523

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/eissn/1533-4406

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_ED7ACB0512709

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Serveur Académique Lausannois

Organisation

Université de Lausanne et CHUV

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info:eu-repo/semantics/openAccess , Copying allowed only for non-profit organizations , https://serval.unil.ch/disclaimer

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M.B. Faries et al., « Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma. », Serveur académique Lausannois, ID : 10.1056/NEJMoa1613210

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Sentinel-lymph-node biopsy is associated with increased melanoma-specific survival (i.e., survival until death from melanoma) among patients with node-positive intermediate-thickness melanomas (1.2 to 3.5 mm). The value of completion lymph-node dissection for patients with sentinel-node metastases is not clear. In an international trial, we randomly assigned patients with sentinel-node metastases detected by means of standard pathological assessment or a multimarker molecular assay to immediate completion lymph-node dissection (dissection group) or nodal observation with ultrasonography (observation group). The primary end point was melanoma-specific survival. Secondary end points included disease-free survival and the cumulative rate of nonsentinel-node metastasis. Immediate completion lymph-node dissection was not associated with increased melanoma-specific survival among 1934 patients with data that could be evaluated in an intention-to-treat analysis or among 1755 patients in the per-protocol analysis. In the per-protocol analysis, the mean (±SE) 3-year rate of melanoma-specific survival was similar in the dissection group and the observation group (86±1.3% and 86±1.2%, respectively; P=0.42 by the log-rank test) at a median follow-up of 43 months. The rate of disease-free survival was slightly higher in the dissection group than in the observation group (68±1.7% and 63±1.7%, respectively; P=0.05 by the log-rank test) at 3 years, based on an increased rate of disease control in the regional nodes at 3 years (92±1.0% vs. 77±1.5%; P

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Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma.

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