For patients with RT-PCR-positive but histologically negative SLNs who received CLND plus interferon, or CLND only, compared with the observation-only group, 5-year OS was 86.
The trial found that HDI therapy after CLND did not improve DFS or OS for patients with minimal nodal tumor burden.
In patients with stage I or II melanoma who have tumor-negative SLNs by hematoxylin and eosin histopathology and immunohistochemistry, but have molecular evidence of melanoma by RT-PCR analysis, no significant differences were observed among patients randomly assigned to CLND or CLND plus interferon treatment.
Critics did not believe that CLND could have been done in only 1,470 of 2,942 patients with a positive sentinel lymph node biopsy (SLNB), or that CLND rates were even lower at NCCN/ NCI centers.
The findings are provocative because current NCCN guidelines recommend that CLND should be performed for sen- tinel lymph node-positive melanoma, and that CLND and SLNB should generally be performed in separate operations to allow for detailed histologic examination.
Sondak took umbrage with the finding that only 42% of patients (615/1,470) underwent CLND as a separate surgery after their SLNB.
Because nitrogen is a universal element, the applications that have appeared for the CLND
include protein analysis, peptide mapping, metabolites quantitation, combinatorial chemistry libraries characterization, polymer quantitation, and many other nitrogen-specific applications.