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Evidence Helps Refine Melanoma Management


 

Complication rates of complete lymph node dissection are generally high, and they tend to be higher after inguinal procedures (48%–84%) than after axillary ones (47%–53%), he noted.

Several trials have shown that adjuvant high-dose interferon therapy modestly improves outcomes among patients with melanoma at high risk for recurrence, but with the tradeoff of substantial toxicity. The benefits are lost when the dose is reduced and therapy is shortened. "But there may be a subgroup in which interferon is useful," he added, so an individualized approach, with discussion of risks and benefits, is needed. It should not be given automatically "because it's the only thing that's available," he said.

The optimal approach to follow-up of patients with treated melanoma has not been established, but follow-up is typically lifelong and multidisciplinary, according to Dr. Dzwierzynski. Importantly, all patients must have lymph node palpation for detection of recurrences, and full-body skin checks for detection of second primaries.

Dr. Dzwierzynski reported that he had no conflicts of interest in association with his presentation.

'Don't do frozen sections on melanoma—you get a lot of false-negatives and a lot of false-positives.'

Source Dr. Dzwierzynski

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