Sentinel lymph node mapping in melanoma in the twenty-first century

Area of Science:

• Oncology
• Dermatology
• Surgical Pathology

Background:

• Melanoma incidence is rapidly increasing, posing a significant public health challenge.
• Regional lymph node status is the primary prognostic indicator in melanoma patients.
• Sentinel lymph node biopsy (SLNB) is the standard for staging intermediate-thickness melanoma (1.01-4.0 mm).

Purpose of the Study:

• To review the current literature on the utility and controversies of SLNB across different melanoma thickness categories.
• To evaluate the role of SLNB in thin, intermediate, thick, and desmoplastic melanoma.
• To assess emerging data on advanced radiopharmaceuticals and imaging for sentinel lymph node mapping.

Main Methods:

• Comprehensive literature review of studies on sentinel lymph node biopsy in melanoma.
• Analysis of data concerning melanoma thickness and desmoplastic subtype.
• Evaluation of recent advancements in radiopharmaceuticals and imaging techniques for SLNB.

Main Results:

• SLNB is recommended for intermediate-thickness melanoma.
• The use of SLNB in thin, thick, and desmoplastic melanoma remains debated.
• Newer radiopharmaceuticals and imaging modalities show promise for improved sentinel lymph node detection.

Conclusions:

• SLNB plays a vital role in melanoma staging, with established indications for intermediate-thickness tumors.
• Further research is needed to clarify the optimal role of SLNB in specific melanoma subtypes.
• Advancements in mapping technology may enhance the accuracy and applicability of SLNB in melanoma management.