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Selective lymph node dissection in patients with intermediate thickness melanoma: our experience.
F Cafiero1, A Peressini, P L Percivale
1Department of Surgical Oncology, University of Genoa, Italy.
Anticancer Research
|April 19, 2000
Summary
Sentinel lymph node biopsy using blue dye and radioguided surgery effectively identifies melanoma metastasis. This technique reliably selects patients needing further lymph node dissection, improving melanoma treatment accuracy.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- The necessity of elective lymph node dissection (ELND) in cutaneous melanoma treatment remains debated due to unproven survival benefits.
- Lymphatic mapping, initially using vital blue dye and later enhanced by radioguided surgery (RGS), aids in detecting occult lymph node metastases.
Purpose of the Study:
- To evaluate the effectiveness and reliability of sentinel node biopsy (SNB) using combined vital blue dye and RGS for melanoma staging.
- To determine the utility of SNB in selecting patients for lymph node dissection.
Main Methods:
- A sentinel node biopsy was performed on 71 patients with stage pT2/T3N0M0 melanoma.
- Lymphatic mapping utilized vital blue dye alone in 39 patients and a combination of blue dye and RGS in 32 patients.
- Sentinel nodes (SN) were identified in 97.2% of patients.
Main Results:
- Metastatic melanoma cells were detected in the SN(s) of 16 patients (23.2%).
- All patients with metastatic SNs underwent dissection of the affected lymph node basin.
- The combined blue dye and RGS technique demonstrated high efficacy in SN identification.
Conclusions:
- Intraoperative detection of sentinel nodes using both blue dye and RGS is an effective and reliable method.
- This combined technique accurately selects patients who require lymph node dissection for cutaneous melanoma.
- SNB improves the precision of staging and treatment planning for melanoma patients.