ABSTRACT
Patients were monitored postoperatively by means of clinical examination, blood testing, and chest radiography every 3 months for 2 years, every 4 months in year 3, every 6 months in years 4 and 5, and annually after 5 completed years. Eligible patients were randomly assigned to wide excision of the primary melanoma plus sentinel lymph node biopsy (SLNB) or wide excision alone and observation. For intermediate thickness melanoma a 2 to 3 cm margin was recommended. Researchers found no significant survival benefit between the two groups and subsequently recommended observation only for micrometastases of 1 mm or less, avoiding the need for a completion lymphadenectomy. With the advent of biologics and immunotherapy people have better ways of treating SNLB-positive patients, and in the future SLNB will not only offer prognostic information, it will be a key investigation prior to the start of systemic therapies in resected disease.
