Completion lymph node dissection after a positive sentinel node: no longer a must?

Stijn Ploeg, Alexander Akkooi, Kees Verhoef, Lex Eggermont

Research output: Contribution to journalArticleAcademic

24 Citations (Scopus)


Purpose of review Sentinel node biopsy (SNB) for primary melanoma is accepted worldwide as a diagnostic procedure. When sentinel node positive, the invasive completion lymph node dissection (CLND) is usually performed. Approximately 20% of CLND patients have nonsentinel node (NSN) metastases. The therapeutic benefit is unknown. This review analyzed the necessity of CLND in sentinel node positive patients. Recent findings Prognosis of sentinel node positive patients is highly heterogeneous. The Rotterdam and Dewar criteria and S-classification are important sentinel node tumor burden criteria to stratify melanoma patients for prognosis and risk of NSN metastases. Patients with less than 0.1 mm metastases seem to have similar prognosis as sentinel node negative patients, especially when located in the subcapsular area. This depends on the use of an extensive sentinel node pathology protocol identifying possibly cl Summary Consensus on the sentinel node pathology work-up and analysis protocols are crucial for correct risk stratification and for clinical decision-making. Primary and sentinel node tumor burden parameters and patient comorbidities should be taken into consideration when offering CLND to an individual patient. In the future, prospective studies such as the MSLT-II and the EORTC 1208 (Minitub) will provide answers to whether CLND has a therapeutic benefit and to which patients might safely be spared CL
Original languageUndefined/Unknown
Pages (from-to)152-159
Number of pages8
JournalCurrent Opinion in Oncology
Issue number2
Publication statusPublished - 2013

Research programs

  • EMC MM-03-47-11

Cite this