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ESSO 45 | The evidence gap in omitting sentinel lymph node biopsy in melanoma

Hesham Mohamed • 4 Nov 2026
ESSO 45
Melanoma Skin Cancer

Hesham Mohamed, MBBch, The Royal Marsden NHS Foundation Trust, London, UK, comments on the current evidence gap regarding sentinel lymph node omission in melanoma treatment, noting that existing data remains at level five evidence with no prospective trials specifically examining this approach. He underscores the clinical importance of lymph node assessment for patient understanding of disease spread, prognosis, staging, and subsequent adjuvant treatment decisions during multidisciplinary team discussions. This interview took place at the 2026 European Society of Surgical Oncology (ESSO) Annual Meeting in Madrid, Spain.

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Transcript

So, there is an argument that the overall survival might not change...
So, there is an argument that the overall survival might not change. The patient maybe will have significantly overall survival comparable ratio if you do it or not do it, but we don’t have enough data at the moment. So, there are some speculations. It’s a level five evidence at the point. There is no prospective trial. There are no trials that included sentinel and lymph node omission. So the keynote trial which is the biggest trial that looked at that recently included sentinel lymph node negative as part of the inclusion into the trial. So we don’t have information regarding the sentinel lymph node omission completely. So the patient’s understanding for the disease and how it’s spread in their body, that’s quite significant for the patients. The choices of the adjuvant treatment they will get and the understanding for their prognosis and the stage they’re in. It’s quite important having this information in the discussion during the MDT and for the patient themselves when we do this kind of decisions.

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The content of VJOncology is intended for healthcare professionals