A patient has a 1.6 mm ulcerated truncal melanoma. Wide excision is complete and sentinel-node biopsy shows a 0.4 mm micrometastasis. Ultrasound

Question

A patient has a 1.6 mm ulcerated truncal melanoma. Wide excision is complete and sentinel-node biopsy shows a 0.4 mm micrometastasis. Ultrasound surveillance of the basin is feasible and recurrent nodal disease would not be unusually difficult to manage. What is the NICE-aligned axillary strategy?

Accepted Answer

Do not routinely offer completion lymph-node dissection; discuss nodal surveillance and the exceptional indications

Answer

Routine completion lymph-node dissection for every positive sentinel node

Answer

No further staging or surveillance because the deposit is below 1 mm

Answer

Adjuvant radiotherapy to the nodal basin instead of multidisciplinary discussion

Answer

Immediate elective dissection of all clinically negative nodal basins

Merkel Cell Carcinoma Local — SCE Medical Oncology MCQ

A patient has a 1.6 mm ulcerated truncal melanoma. Wide excision is complete and sentinel-node biopsy shows a 0.4 mm micrometastasis. Ultrasound surveillance of the basin is feasible and recurrent nodal disease would not be unusually difficult to manage. What is the NICE-aligned axillary strategy?