Clinical Snippets

For years, lymph node dissection in breast cancer and melanoma was justified based on the belief that regional lymph nodes are the first sites of metastasis and that distant metastases originate from these metastatic lymph nodes. In a single-center study of 2,299 patients with cutaneous metastatic melanoma, Gassenmaier and colleagues found that development of regional and distant metastases is not a serial process, but that it most likely occurs in parallel. Furthermore, distant metastasis-free and overall survival did not differ between patients with primary hematogenous metastasis and those with primary lymphatic metastasis.

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