The value of sentinel node mapping for staging melanoma

One of the most important prognostic features of malignant melanoma is the involvement of regional lymph nodes. Sentinel lymph node biopsy (SLNB) is increasingly used to stage melanoma in order to avoid lymph node dissection in patients who clinically have no lymph node involvement. We present a prospective study of 27 patients who underwent SLNB from November 1999. Lymphoscintigraphy was done on the day of surgery, and SLNB guided by blue dye and/or gamma probe performed. A sentinel node was identified in all 27 patients, mean age 46 years. The mean Breslow thickness was 1.63mm. Excision of 1-3 sentinel nodes (mean 1.5) was performed. In 3/27 patients metastatic disease was detected in the sentinel node, 2 patients had therapeutic lymph node dissections, and one had chemotherapy. There were no major complications. SLNB is a valuable technique for staging melanoma, however impact on overall survival requires longer follow up.