Survival impact of sentinel lymphadenectomy

Figures & data

Figure 1. Schematic representation of two competing hypotheses for nodal metastases.

The incubator hypothesis: primary melanoma spreads first to regional draining nodes and only subsequently to distant sites. The marker hypothesis: spread occurs simultaneously to nodal and distant sites.

Figure 2. Extent of melanoma spread in patients with clinically localized disease.

The majority of cases (80%) are limited to the primary site, while a smaller fraction (6%) have disease already beyond the regional nodes. Only those with nodal disease but not systemic disease (14%) will be cured by early nodal excision.

Figure 3. Melanoma-specific survival in the Multicenter Selective Lymphadenectomy Trial clinical trial.

Subgroup 1: patients with positive sentinel lymph node (SLN). Subgroup 2: those with positive SLN or false-negative SLN. Subgroup 3: those with nodal recurrence in the wide excision-alone arm.

Subgroup 4: those with false-negative SLN.

Redrawn with permission from [7] © 2006 Massachusetts Medical Society. All rights reserved.

Morton DL, Thompson JF, Cochran AJ et al. Sentinel-node biopsy or nodal observation in melanoma. N. Engl. J. Med.355(13), 1307–1317 (2006).

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