Melanoma patients who remove lymph nodes don't live longer

MIAMI - 8 June 2017: People diagnosed with melanoma who then undergo surgery to have lymph nodes removed near the original tumor site do not live longer than patients who forego this common operation, researchers said Wednesday.

The report in the New England Journal of Medicine was based on a study of more than 1,900 patients with melanoma, the deadliest kind of skin cancer, at more than 60 medical institutions worldwide.

When people are newly diagnosed with melanoma that has spread to one or more lymph nodes, they must decide whether or not to undergo extensive surgery to remove all the remaining nodes in that area of the body.

The procedure, called completion lymph node dissection, is considered the standard of care.

"The new findings likely will result in many fewer of these procedures being performed around the world," said lead author Mark Faries, co-director of the melanoma program and head of Surgical Oncology at The Angeles Clinic and Research Institute, an affiliate of Cedars-Sinai.

"The results also will likely affect the design of many current and future clinical trials of medical therapies in melanoma."

The removal of the nodes did help doctors better determine how much the cancer had spread, and in some cases prolonged the amount of time patients were disease-free, but did not translate to longer lives.

Side effects were also frequent in those who had the surgery.

Almost one quarter of patients suffered from lymphedema, swelling that may result when lymph nodes are damaged or removed and which may cause hardening of the skin, infections and restricted range of motion.

"This is a larger operation that has a higher risk of complications," Faries said, "including wound infection and nerve damage."

Faries said the report suggests the "larger procedure will remain an option for some patients, but it will no longer be the only 'standard' option."

Melanoma kills more than 10,000 people each year in the United States.