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Sentinel node biopsy and selective lymph node dissection in cutaneous melanoma patients
L Lenisa1, M Santinami, F Belli
1Dept. of General Surgery, Casa di Cura S. Pio X, Milan, Italy.
Journal of Experimental & Clinical Cancer Research : CR
|June 22, 1999
Summary
Sentinel node biopsy accurately selects melanoma patients for dissection. This safe and feasible technique identifies metastatic nodes, guiding treatment and improving patient outcomes with no reported complications.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Melanoma staging requires accurate assessment of lymph node involvement.
- Sentinel node biopsy (SNB) is a minimally invasive technique to identify the first lymph node(s) draining a tumor site.
Purpose of the Study:
- To evaluate the feasibility, safety, and efficacy of SNB in stage I melanoma patients.
- To determine the sentinel node positivity rate and its correlation with primary melanoma thickness.
Main Methods:
- A prospective study of 580 SNBs in 540 stage I melanoma patients.
- Utilized blue dye injection for identification; lymphoscintigraphy and intraoperative gamma probe were employed in a subset of patients.
- Analyzed sentinel node positivity rates based on primary tumor thickness and patient demographics.
Main Results:
- Sentinel node identification rate was 91%, with a positivity rate of 15%.
- Higher rates of metastasis were observed in thicker melanomas (2-2.99 mm: 18%; ≥3 mm: 27%).
- The sentinel node was the only metastatic node in 77% of dissected patients; 8 patients experienced regional relapse after negative SNB.
Conclusions:
- SNB is a feasible and safe procedure for selecting stage I melanoma patients for therapeutic lymph node dissection.
- Preoperative lymphoscintigraphy and intraoperative gamma probe use enhance SNB identification rates.
- SNB aids in appropriate patient selection for further treatment and surveillance, contributing to positive patient outcomes.