Application Detail

Status

Closed

Description of Medical Service

Sentinel lymph node biopsy (SLNBx) is a procedure performed to determine if melanoma cells have spread to the sentinel lymph nodes for patients with intermediate thickness melanoma.

SLNBx with excision of lymph node(s) is identified by a combination of blue dye (lymphotropic dye injection) and lymphoscintography/gamma probe, ideally performed at the time of the primary melanoma wide excision.

Description of Medical Condition

Melanoma is a malignancy of skin pigment cells (melanocytes). The lifetime risk for melanoma in Australia is 1 in 24 for males and 1 in 35 for females. In 2011 there were 11,500 new cases diagnosed in Australia (Cancer Council Australia) and more than 1,500 die each year from the disease.

About 70% of cases are diagnosed at an early stage (<1.0mm thickness) where 5-year survival is > 95%. With increasing depth, there is a stepwise decline in survival. Sentinel node status is the most significant prognostic indicator in patients with intermediate thickness melanoma. Patients with intermediate thickness melanoma (1.0-4.0mm depth) have an increased risk of lymph node involvement and hence poorer survival.

Reason for Application

New MBS item

Medical Service Type

Investigative

Previous Application Number

Not Applicable

Associated Documentation

Application Form

Completed Application Form (PDF 698 KB)
Completed Application Form (Word 103 KB)

PICO Confirmation

Draft PICO Confirmation (Word 571 KB)
Draft PICO Confirmation (PDF 856 KB)

Assessment Report

-

Public Summary Document

Public Summary Document (PDF 263 KB)
Public Summary Document (Word 100 KB)

Meetings for this Application

PASC

11 August 2017

ESC

8 June 2018

MSAC

26-27 July 2018

Stakeholder Meeting

Wednesday 7 November 2018, members of MSAC, clinicians with experience and expertise in clinical oncology, pathology, dermatology and clinical genetics; representatives of the applicant; representatives from consumer organisations; and representatives from the Department of Health met to discuss sentinel lymph node biopsy for intermediate thickness and thick melanoma. This was not an MSAC decision forum, but a meeting that would inform the issues considered by MSAC, following its July 2018 consideration of application 1485. The final minutes of this meeting are below.

Final Stakeholder Meeting Minutes (PDF 374 KB)
Final Stakeholder Meeting Minutes (Word 57 KB)