GAMMA-PROBE-GUIDED SENTINEL LYMPHONODECTO MY IN MALIGNANT-MELANOMA

In cutaneous melanoma, biopsy of the first tumor-draining lymph node ( Sentinel node, SLN) may replace routine elective lymph-node dissection (ELND). The SLN has been shown to contain the first micrometastasis i n early lymphatic tumor dissemination. As micrometastases were identif ied in 10-30 % of stage I (AJCC/UICC) patients, sentinel lymphonodecto my (SLND) should enable us to select patients clinically in stages I a nd II, but histopathologically in stage III. This optimization of pati ent selection is mandatory, as only this subgroup profits from ELND. S ince the beginning of 1995 we was scintillation detector (gamma probe) -guided sentinel biopsy in patients with a melanoma > 1.0 mm and clini cally negative lymph nodes. After injecting colloidal (99m)-Tc-labelle d tin(II)-sulfide solution around the tumor (or the biopsy scar), the SLN can be localized exactly. The technique is minimally invasive and easy to handle. If the SLN contains tumor, a standard en bloc lymphono dectomy is performed. Long-term follow-up, however, is needed to delin eate the role of this procedure in melanoma treatment.