Management of metastases in regional lymph nodes in melanoma patients in 2019

For several years, the standard of management in case of melanoma metastases in regional lymph nodes was to remove an adequate node group. In 2016 and 2017, the results of two large, well-designed clinical trials with randomization and a control group were published, which changed the current management. The authors of DeCOG-STL study came to the conclusion that withdrawal from completion lymph node dissection in the case of a small melanoma metastasis in a sentinel lymph node (metastasis diameter ≤1 mm) is not associated with a worsening of the 3-years’ survival chance (both in terms of overall survival and survival time to the occurrence of distant metastases). The results of MSTL-II study were similar. Based on the results of both studies presented above, in 2018 the American Society of Clinical Oncology (ASCO) and the Society of Surgical Oncology (SSO) presented joint recommendations concerning, among others, current indications for completion lymph node dissection in SNB positive melanoma patients

Radiotherapy or axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes?

Over the years the surgical management of localized breast cancer has become less aggressive. Complete resection of the primary tumour with negative margins replaced mastectomy and is currently a standard of care in a vast ma­jority of women with early breast cancer. Also, an introduction of sentinel lymph node biopsy allowed for giving up axillary lymph node dissection in the patients with pathologically negative sentinel nodes. This development has led to a decrease of morbidity such as lymphedema. However, the standard management of axilla in the patients with positive sentinel lymph nodes remains controversial. Recent studies demonstrated that in the patients with 1 or 2 positive sentinel lymph nodes who undergo breast conserving surgery followed by conventionally fractionated whole-breast radiotherapy, a completion axillary lymph node dissection can be avoided. Furthermore, evidence from three two-phase non-inferiority studies comparing radiotherapy with complete lymph node dissection did not show any significant differences in either overall and disease-free survival, or local control and decrease of the percentage of patients with local adverse effects in radiotherapy arms. However, there are several methodological drawbacks and clinical limitations of these studies, which prevent from general omission of completion axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes. The debate held during V Annual Conference of Nowotwory Journal of Oncology and resulting article discusses the optimal management of axilla in this population

Serwis CancerMath.net

W cyklu ukazującym się w Nowotworach, dotyczącymzasobów internetowych przydatnych onkologom, już kilkakrotnieopisywano różne kalkulatory medyczne. Mimo to,biorąc pod uwagę praktyczną wartość takich stron internetowych,a także rozpowszechnienie telefonów pozwalającychna korzystanie z tych stron bezpośrednio przy łóżkuchorego, warto rekomendować kolejne dostępne onlinekalkulatory medyczne

Serwis Cochrane Summaries

W niniejszym odcinku cyklu internetowego Nowotworówchciałbym uwagę Czytelników skierować w stronęjednego z serwisów opracowanych i utrzymywanychprzez Cochrane Collaboration.W niniejszym odcinku cyklu internetowego Nowotworówchciałbym uwagę Czytelników skierować w stronęjednego z serwisów opracowanych i utrzymywanychprzez Cochrane Collaboration