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COPYRIGHT 2008 International Medical News Group
CHICAGO -- Only half of close to 3,000 patients with a positive sentinel lymph node biopsy underwent a completion lymph node dissection in a controversial retrospective analysis of 47,643 patients with invasive melanoma that suggests common practice is falling far short of guidelines.
Even more surprising, 64% of positive patients at National Comprehensive Cancer Network (NCCN)/National Cancer Institute (NCI) centers did not undergo a completion lymph node dissection (CLND), according to findings presented at a symposium sponsored by the Society of Surgical Oncology.
Patients were significantly less likely to undergo CLND if they were older than 75 years (odds ratio 0.56), had lower--extremity melanomas (OR 0.63), had lesions 1.0 mm or less in thickness (OR 0.80), or underwent surgery at low-volume, community, or academic hospitals compared with high-volume or NCCN/NCI centers (p less than .0001), lead investigator Dr. Karl Y. Bilimoria reported.
The presentation by Dr. Bilimoria, a research fellow with the American College of Surgeons, stirred a...
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