Patients with melanoma who underwent immediate completion lymph node dissection did not live any longer than patients who were instead closely monitored, according to a new study published in the New England Journal of Medicine.

Subjects in the clinical trial all had melanoma that had metastasized to the sentinel node, the first involved in lymphatic spread.

Jeffrey Wayne, MD, professor of Surgery and Dermatology, and chief of Surgical Oncology in the Department of Surgery, was a co–author of the paper.

Sentinel node biopsies are performed on patients with melanoma to help understand whether the cancer might have spread to nearby lymph nodes. If these key lymph nodes are found to be cancerous, patients also typically undergo completion lymph node dissection, where all other lymph nodes in the area are removed and biopsied.

But the procedure can carry significant adverse effects, and there has been little evidence showing a survival benefit.

In the current international study, more than 1,900 patients with melanoma and sentinel–node metastasis were randomized to either receive an immediate dissection, or undergo observation with ultrasounds every four to six months. In that group, surrounding nodes were only removed if cancer was detected.

At three years follow–up, the investigators found no difference in melanoma–specific survival between the two groups.

Further, patients who had received the dissection were significantly more likely to develop lymphedema.

Although the primary endpoint was patient survival, the study did find some small benefits to the dissections: disease–free survival rates were slightly higher in the dissection group, and the procedure also provided physicians with increased prognostic information.