Sentinel lymph node biopsy for melanoma

BACKGROUND: The most powerful predictor of survival for patients with melan oma is the status of the regional lymph nodes. Sentinel lymph node biopsy m ay provide improved staging accuracy without the morbidity of elective lymp h node dissection (ELND). METHODS: Sixty-eight patients with intermediate thickness melanoma underwen t gamma probe guided sentinel node biopsy without ELND and were followed up over a mean of 22 months. RESULTS: A sentinel node was found in all patients. Six patients (9%) had p ositive sentinel nodes; all underwent complete lymphadenectomy. Two patient s (3%) with negative sentinel nodes developed nodal recurrence; 1 of these patients was found to have microscopic disease on reexamination of the sent inel node. Two patients (3%) developed systemic disease. CONCLUSION: Gamma probe guided sentinel node biopsy can be performed with a high rate of technical success. It provides accurate pathological staging with a low incidence of nodal basin failure. Am J Surg. 1998;176:544-547. ( C) 1998 by Excerpta Medica, Inc.