[Use of sentinel lymph node technique in cutaneous melanoma: preliminary experience]

The aim of this study was to determine the contribution of the technique of sentinel lymph node (SLN) biopsy by preoperative lymphoscintigraphy and patent blue injection in management of primary cutaneous melanoma (MM). Sixty three patients with stade I primary MM were operated between March 1999 and January 2003. Preoperative lymphoscintigraphy was performed the day before surgery and peroperative patent blue injection was used to identify SLN. All hot and/or blue lymph nodes were removed and examinated in standard histology and immunohistochemistry. The population was 31 men and 32 women. The MM were distributed between upper extremities (9), lower extremities (24), trunk (19) and head and neck (11). A SLN was identified in 98%. Aberrant drainages were found in 13%. The average number of SLNs removed was 3.6 [0-15]. Fourteen patients (22%) had SLN positive for malignant disease, with micrometastasis in nine cases. The sentinel node was false-negative in 12.5% with a medial follow-up of 14 months. In conclusion, preoperative lymphatic mapping combined used of peroperative detection by a hand-held gamma probe and patent blue injection is a feasible technique to specify the first drainage of MM.