Multicenter Selective Lymphadenectomy Trial 2 (MSLT-2)

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The Multicenter Selective Lymphadenectomy Trial 2 (MSLT-2):
    • Was recently published in June 2017:
      • Which evaluated completion lymphadenectomy versus observation following positive sentinel lymph node biopsies for metastatic melanoma
    • There was no significant difference:
      • In disease-specific survival among the two treatment groups
    • Key limitations to the study were:
      • That it mostly included patients with a low burden of disease (% nodal involvement, largest metastatic focus, and number of positive nodes) in their sentinel lymph nodes
      • The study has limited median follow-up:
        • 43 months
      • Furthermore, it is important to note that there was a significant difference in disease-free survival between groups and that subjects in the study did not receive contemporary systemic therapy
    • Debate remains for which subset of patients would benefit most from completion lymphadenectomy:
      • However, it is reasonable for most of these patients to be observed closely with:
        • Nodal ultrasounds:
          • Every 4 months for the first 2 years
          • Every 6 months for years 3 to 5
          • Then annually.
  • References:
    • Faries MB, Thompson JF, Cochran AJ, et al. Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma. N Engl J Med. 2017; 376(23): 2211-2222.

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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