Sentinel node detection by preoperative lymphoscintigraphy and intraoperative gamma-probe guidance in melanoma

Aim: The purpose of this work was to prove the clinical significance of nuc lear medical procedures in pre- and intraoperative detection of the SLN. Me thods: in the past 4 years, we did preoperative lymphoscintigraphy in 214 p atients (pts.). intraoperative localisation of the SLN with a handheld gamm a probe followed in 150 pts. Results: In 214 pts. 247 lymphatic draining re gions were found by preoperative scintigraphy. in 3 pts. with melanoma of t he cheek no lymphatics/lymphe nodes could be detected. 14 pts. showed inter val lymph nodes. in 150 pts. gamma probe guided SLNE was done. in 2 pts. wi th supraclavicular primary tumor 4 SLN had been defined by preoperative sci ntigraphy but only 2 could be found intraoperatively. In ail other cases (9 8.7%) the sentinel node was detected correctly by the gamma probe and then removed. In 19 of 150 pts. (12.7%) metastases were detected in the patholog ic specimen. The incidence of lymph node metastases showed a continuous inc rease from 0% at tumor stage pT1 to 44% at stage pT4. Conclusion: SLNE is a n accurate method to determine nodal involvement in melanoma and minimizes operative invasiveness in melanoma surgery.