Selective lymph node dissection in patients with intermediate thickness melanoma: Our experience

The role of elective lymph node dissection (ELND)for the treatment of cutan eous melanoma has been debated for many years.Actually, the value of ELND i s seriously questioned because an increasing of overall survival rates has not been demonstrated. The lymphatic mapping technique, initially performed by an intradermic injection of vital blue dye, subsequently improved by th e use of radioguided surgery (RGS), proved effective for the detection of c linical occult lymph none metastasis. We performed a sentinel node biopsy o n 71 patients with stage pT2/T3N0M0 melanoma. Vital blue dye mapping alone was performed on 39 patients; the remaining 32 patients had a combined lymp hatic mapping with both blue dye and RGS. The sentinel node (SN) was comple xively identified in 69/71 (97.2%) patients. Sixteen patients (23.2%) were found to have metastatic melanoma cells in their SN(s); all these patients underwent lymph none dissection of the affected basin.Our experience confir med that the intraoperative detection of sentinel nodes using both blue dye and radio-guided surgery is an effective and reliable technique for select ing patients to be submitted to lymph node dissection.