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Less invasive lymph node biopsy method could spare thousands unnecessary operations
Date:9/26/2007

s is the most important factor influencing the prognosis and treatment plan for patients with melanoma. Lymph node surgery for tumour staging has become more refined and less debilitating over the last decade. Traditional operations involve the removal of all lymph tissue from the area that drains the site of the tumour, but in some cancers, including melanoma, doctors now more often cut out only one or two key nodes, called sentinel nodes. If the sentinel node is free of cancer, patients dont need to have more extensive lymph node removal.

However, only 20 percent of patients who have their sentinel lymph nodes excised have cancer that has spread there, so the operation, which can still be accompanied by side effects such as chronic swelling and seroma, is unnecessary for 80 percent of patients.

Sentinel node biopsy (the excision of only one node instead of all regional lymph nodes) is already an improvement over complete removal of all the lymph nodes in the axilla, groin or neck, but we still need a better way to identify which patients need their sentinel lymph nodes cut out and which dont, so that all those patients who are subjected to unnecessary surgery can avoid it. Ultrasound-guided fine needle aspiration does look better, said Voit, adding that the procedure does not cause the side effects seen in sentinel node biopsy. The sometimes-claimed danger of spreading of tumour cells along the needle tract was not evident in this study, nor in previous studies the group has conducted using the method, Voit added.

The technique, called ultrasound-guided fine needle aspiration cytology, or US-FNAC, has been reported to be useful in replacing the need for a sentinel node biopsy in breast cancer, but has not yet been accepted as a valuable option to avoid surgical sentinel node biopsy in melanoma.


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Contact: Emma Ross
rosswrite@mac.com
34-932-308-832
ECCO-the European CanCer Conference
Source:Eurekalert

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