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Sentinel lymph node biopsy for melanoma: indications and rationale
Giao Q Phan1, Jane L Messina, Vernon K Sondak
1Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA.
Cancer Control : Journal of the Moffitt Cancer Center
|June 27, 2009
Summary
Sentinel lymph node biopsy (SLNB) accurately stages melanoma by assessing lymph node status, improving disease-free survival. SLNB is recommended for melanomas with Breslow depth greater than or equal to 0.76 mm.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Regional lymph node status is a critical prognostic factor in melanoma.
- Sentinel lymph node biopsy (SLNB) aids in surgical staging and spares patients unnecessary complete lymphadenectomies.
Purpose of the Study:
- To review the literature on SLNB for cutaneous melanoma.
- To elucidate the rationale behind the widespread adoption of SLNB.
Main Methods:
- Literature review of studies on SLNB for cutaneous melanoma.
Main Results:
- Positive SLNs significantly correlate with decreased disease-free and melanoma-specific survival.
- In the MSLT-I trial, SLNB improved 5-year disease-free survival compared to observation alone.
- SLNB with immediate lymphadenectomy improved survival for patients with nodal metastases compared to delayed dissection.
Conclusions:
- SLNB offers crucial prognostic and staging information with minimal morbidity.
- It identifies patients who do not require complete lymph node dissection.
- SLNB is recommended for melanomas with Breslow depth ≥ 0.76 mm, provided surgical risks are acceptable.
