Angeles CV, et al. - In this systematic review and meta-analysis, researchers assessed survival and recurrence rate in patients with sentinel lymph node (SLN)-positive melanoma who had completion lymph node dissection (CLND) vs observation. Outcomes revealed CLND offered no significant benefit in survival or recurrence rate in patients vs observation.

Methods

• Researchers sought cohort studies and RCTs published between January 2000 and June 2017 that assessed the outcomes of CLND vs observation in patients with SLN-positive melanoma via performing a comprehensive MEDLINE and Embase database search.
• Survival was assessed as the primary outcome and recurrence rate was assessed as the secondary outcome.
• The Cochrane risk-of-bias tool was used to assess the quality of RCTs and Newcastle–Ottawa Scale was used for cohort studies.
• For each outcome, they calculated pooled relative risk or hazard ratio with 95 % confidence intervals, and the I₂ test was used to assess the extent of heterogeneity between studies.

Results

• For qualitative synthesis, researchers identified 15 studies (13 cohort studies with 7,868 patients and 2 RCTs with 2,228 patients); quantitative meta-analysis was done on 13 remaining studies.
• Patients who underwent CLND had survival comparable to those who were observed (risk ratio for death 0.85, 95 % ci 0.71 to 1.02).
• Furthermore, recurrence rate in the groups was also comparable (RR 0.91, 0.79 to 1.05).