Sentinel lymph node mapping in the management of high risk malignant melanoma

In patients with malignant melanoma, the selective biopsy of the first drai ning lymph node, so-called the sentinel lymph node, allows to identify, wit h a low morbidity, the patients with nodal metastasis that require radical lymphadenectomy and adjuvant systemic chemotherapy. Herein, we report our i nitial experience in sentinel lymph node biopsy in 16 patients with maligna nt melanoma. The sentinel lymph node was localised using preoperative lymph oscintigraphy and injection of dye blue. Intraoperatively, the dissection w as guided with a gamma probe and by the recognition of the blue nodes. In t he 16 cases the sentinel lymph node was localised. In 50% of the cases, mul tiple sentinel nodes were demonstrated at lymphoscintigraphy and found duri ng surgery. A limited postoperative morbidity was observed in three cases. Three patients presented nodal metastasis and underwent further radical lym phadenectomy. We conclude that sentinel lymph node mapping is a feasible an d reproductive procedure. The preoperative lymphoscintigraphy is essential to identify multiple sentinel nodes and guide surgical dissection. The impa ct of this approach on the overall survival of patients with high-risk mela noma has still to be demonstrated in studies with a long follow-up.