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Sentinel node biopsy in patients with cutaneous melanoma
F Cafiero1, A Peressini, M Gipponi
1Department of Clinical and Experimental Oncology, University of Genoa, Italy.
Seminars in Surgical Oncology
|November 26, 1998
Summary
Radioguided surgery (RGS) combined with blue dye effectively identifies sentinel lymph nodes (SLNs) in melanoma patients. This technique aids in selecting patients for selective lymph node dissection (SLND), improving treatment accuracy.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- The role of elective lymph node dissection (ELND) in cutaneous melanoma management remains controversial.
- Lymphatic mapping has evolved from vital blue dye to include radioguided surgery (RGS).
- Selective lymph node dissection (SLND) aims to identify node-positive patients for targeted treatment.
Purpose of the Study:
- To evaluate the efficacy of combined vital blue dye and RGS for sentinel lymph node biopsy (SLNB) in melanoma.
- To determine the utility of SLNB in selecting patients for SLND.
- To assess the detection rate of lymph node metastasis in stage pT3N0M0 melanoma.
Main Methods:
- Sentinel node biopsy performed on 48 patients with stage pT3N0M0 melanoma.
- Lymphatic mapping utilized vital blue dye in 39 patients and combined blue dye with RGS in nine.
- Sentinel lymph node (SLN) identification and analysis for metastatic melanoma cells.
Main Results:
- The SLN was successfully identified in 46 out of 48 patients (95.8%).
- Metastatic melanoma cells were found in the SLN of 10 patients (20.8%).
- All 10 patients with positive SLNs underwent SLND of the affected basin.
Conclusions:
- Intraoperative lymphatic mapping using both blue dye and RGS is a reliable technique for SLN identification.
- This combined approach effectively selects melanoma patients who may benefit from lymph node dissection.
- SLNB facilitates a more targeted approach to lymph node management in cutaneous melanoma.