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Review
. 2012 Oct;29(7):699-706.
doi: 10.1007/s10585-012-9503-3. Epub 2012 Jun 24.

Overview and update of the phase III Multicenter Selective Lymphadenectomy Trials (MSLT-I and MSLT-II) in melanoma

Donald L Morton  1
Affiliations
Review

Overview and update of the phase III Multicenter Selective Lymphadenectomy Trials (MSLT-I and MSLT-II) in melanoma

Donald L Morton. Clin Exp Metastasis. 2012 Oct.

Abstract

This short review offers an update on the first and second Multicenter Selective Lymphadenectomy Trials (MSLT-I and MSLT-II) for patients with melanoma, and briefly traces the development of intraoperative lymphatic mapping and sentinel node biopsy.

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Figures

Fig. 1
Fig. 1
Incubator versus marker hypothesis. Reprinted with permission from Morton et al.
Fig. 2
Fig. 2
Cutaneous lymphoscintigraphy performed with colloidal gold shows bilateral drainage from a truncal melanoma. This patient underwent elective bilateral axillary dissections; both nodal specimens were positive. Reprinted with permission from Holmes et al.
Figure 3
Figure 3
Design of MSLT-I.
Figure 4
Figure 4
Cumulative incidence of nodal metastases by treatment arm of MSLT-I. Reprinted with permission from Morton et al. Copyright 2007 Massachusetts Medical Society. All rights reserved.
Figure 5
Figure 5
Melanoma-related survival of 764 patients with tumor-positive versus tumor-negative sentinel node metastases from intermediate-thickness melanomas. Reprinted with permission from Morton et al. Copyright 2006 Massachusetts Medical Society. All rights reserved.
Figure 6
Figure 6
Incidence of lymphedema and hospital length of stay among patients undergoing immediate lymphadenectomy for a positive sentinel node versus delayed lymphadenectomy for nodal recurrence during observation. Adapted with permission from Faries et al.
Figure 7
Figure 7
Design of MSLT-II.
Figure 8
Figure 8
International sites participating in MSLT-I and MSLT-II.
See this image and copyright information in PMC

References

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    1. Morton DL, Hoon DS, Cochran AJ, et al. Lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: therapeutic utility and implications of nodal microanatomy and molecular staging for improving the accuracy of detection of nodal micrometastases. Ann Surg. 2003;238:538–49. discussion 49–50. - PMC - PubMed
    1. Holmes EC, Moseley HS, Morton DL, Clark W, Robinson D, Urist MM. A rational approach to the surgical management of melanoma. Ann Surg. 1977;186:481–90. - PMC - PubMed
    1. Morton DL, Cochran AJ, Thompson JF, et al. Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg. 2005;242:302–11. discussion 11–3. - PMC - PubMed
    1. Balch CM, Soong S, Ross MI, et al. Long-term results of a multi-institutional randomized trial comparing prognostic factors and surgical results for intermediate thickness melanomas (1.0 to 4.0 mm). Intergroup Melanoma Surgical Trial. Ann Surg Oncol. 2000;7:87–97. - PubMed