LYMPHATIC MAPPING AND SENTINEL LYMPHADENECTOMY FOR MELANOMA

Intraoperative lymphatic mapping and sentinel lymphadenectomy (SLND) f or patients with clinical Stage I melanoma was developed to determine the tumor status of the regional lymphatic basin without elective regi onal node dissection. Only individuals with histologically confirmed s entinel node (SN) metastases undergo complete regional node dissection , sparing those with tumor-free SN the morbidity of this procedure. St udies worldwide have confirmed the validity of the SN concept and the accuracy of SLND as a staging procedure. The incidence of false-negati ve SN and the rate of recurrence in the regional node basin have been low. Routine preoperative lymphoscintigraphy and refinements in surgic al technique have the accuracy of SLND for melanoma, making it the nod al staging procedure of when undertaken by an experienced nuclear medi cine physician, surgical oncologist and pathologist. Ongoing studies a re investigating the impact of SLND on survival as well as the prognos tic significance of micrometastasis detected by histopathologic and mo lecular techniques. (C) 1998 Wiley-Liss, Inc.