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Updated: Jul 25, 2026

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Sentinel lymph node biopsy for melanoma: experience with 234 consecutive procedures.

J D Wagner1, L Corbett, H M Park

  • 1Department of Surgery, Indiana University School of Medicine at Indiana University Purdue University at Indianapolis, USA. jdwagner@iupui.edu

Plastic and Reconstructive Surgery
|June 6, 2000
PubMed
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Sentinel lymph node biopsy (SLNB) is reliable for melanoma staging in experienced hands. It is most beneficial for patients with thicker melanomas (>1.2 mm), ulceration, or high mitotic index, identifying occult metastases.

Area of Science:

  • Oncology
  • Surgical Pathology
  • Dermatology

Background:

  • Sentinel lymph node biopsy (SLNB) is a key staging procedure for cutaneous melanoma, aiming to detect occult metastases.
  • Patient selection for SLNB and subsequent lymphadenectomy remains a subject of clinical debate.
  • Accurate identification of patients benefiting from SLNB is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To analyze a large clinical series of SLNB procedures for cutaneous melanoma.
  • To identify specific patient and tumor characteristics predictive of positive SLNB results.
  • To evaluate the utility of SLNB in guiding further management decisions.

Main Methods:

  • Retrospective analysis of a database of patients with clinically localized cutaneous melanoma who underwent SLNB.

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  • SLNB performed using preoperative technetium Tc 99m lymphoscintigraphy and isosulfan blue dye.
  • Statistical analyses including univariate and multivariate logistic regression and classification tables to identify predictors of nodal positivity.

    • Main Results:

    • Of 234 SLNB procedures, 20.1% were positive for melanoma metastasis.
    • Melanoma thickness (Breslow's), ulceration, and mitotic index were significant predictors of positive SLNB.
    • A Breslow thickness cutpoint of 1.2 mm demonstrated high efficiency in predicting SLNB positivity.
    • Completion lymphadenectomy in positive SLNB cases revealed additional positive nonsentinel nodes in 26.1% of patients.

    Conclusions:

    • Sentinel lymph node biopsy is a highly reliable staging tool for melanoma when performed by experienced teams.
    • SLNB is particularly valuable for identifying occult metastases in patients with melanomas >1.2 mm, or those with ulceration or high mitotic index.
    • Completion lymphadenectomy is recommended following a positive SLNB due to the difficulty in predicting nonsentinel node involvement.