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Surveillance and Survivorship in Sentinel Lymph Node Positive Melanoma

Kelsey Montgomery

Mentor Kristy Broman, MD, MPH
Award Type Resident Fellow Award
Institution University of Alabama at Birmingham
Donor Support In honor of Richard Draeger
Melanoma, an aggressive skin cancer, can spread cancer cells to nearby lymph nodes. When removing a melanoma, surgeons will often also remove one or more lymph nodes from the basin, or collection, of lymph nodes nearest to the cancer. This is called a sentinel lymph node (SLN) biopsy, and helps determine if cancer has spread to lymph nodes. Previously, if cancer cells were seen in the SLN (SLN+), all other lymph nodes in that nodal basin would be removed through a completion lymph node dissection (CLND). While this procedure helped reduce the risk that melanoma would come back, it also put patients at risk for lymphedema, which can lead to severe swelling in the arm or leg. Over the past five years, there has been a dramatic shift in treatment for patients with SLN+ melanoma towards surveillance with frequent ultrasounds and examinations instead of additional surgery. Medical therapies such as immunotherapy have also significantly patients’ likelihood of surviving melanoma-free, which has increased the number of melanoma survivors who need high-quality survivorship care and melanoma surveillance. Our goal in this study is to closely study the outcomes of SLN+ melanoma patients at our institution who are undergoing nodal surveillance, so that we can better understand challenges that they face as melanoma survivors. We will conduct patient surveys to collect detailed information about their melanoma care, including patient-reported quality of life measures. We also want to understand how social determinants of health (SDoH), which are characteristics about the places in which people grow up and live that can influence their health outcomes, might affect patients’ experiences with melanoma survivorship. Findings from this study will help us to be able to identify melanoma survivors whose social needs may put them at higher risk for worse outcomes, so that we can design interventions to address these needs and improve the care of all SLN+ melanoma survivors.