SENTINEL NODE BIOPSY IN PATIENTS WITH CUTANEOUS MELANOMA

The role of elective lymph node dissection (ELND) for treatment of cut aneous melanoma is still debated. Initially, lymphatic mapping techniq ue was performed by an intradermic injection of vital blue dye, subseq uently, it was improved by the use of radioguided surgery (RGS). Preli minary experience with this technique proved effective for detection o f clinical occult lymph node metastasis; it may also enable the surgeo n to perform a selective lymph node dissection (SLND) to concentrate o n pathologic node-positive patients for the same potential benefits th at have been provided by ELND. We performed sentinel node biopsy on 48 patients with stage pT3N0M0 melanoma. Vital blue dye mapping only was carried out on 39 patients; the remaining nine patients had a combine d lymphatic mapping with both blue dye and RGS. The sentinel lymph nod e (SLN) was identified in 46 of 48 patients (95.8%). Ten patients (20. 8%) were found to have metastatic melanoma cells in their SLN(s); all these patients underwent SLND of the affected basin. Our findings conf irm that the intraoperative lymphatic mapping of the SLN using both bl ue dye and radiodetection is an appropriate and simple technique for s electing patients who are more likely to benefit from lymph node disse ction Semin. Surg. Oncol. 15:284-286, 1998. (C) 1998 Wiley-Liss, Inc.