The role of lymphoscintigraphy and sentinel node mapping in assessing patient risk in melanoma

The presence or absence of regional nodal metastases is one of the most important prognostic factors for the survival of patients with primary cutaneous melanoma. The successful outcome of treatment is thus critically dependent on accurate staging of the primary tumor and detection of any occult micrometastases in the regional lymph nodes draining that tumor. Preoperative cutaneous lymphoscintigraphy to identify and visualize the lymphatic drainage patterns from primary tumors and intraoperative lymphatic mapping to identify the first ("sentinel") lymph node in direct communication with the primary tumor are valuable diagnostic tools. These techniques have greatly enhanced the oncologist's ability to identify occult lymph node metastases and to select patients with cutaneous melanoma who may potentially benefit from adjuvant therapy with recombinant interferon alpha-2b.