Gamma probe guided biopsy of the sentinel node in malignant melanoma: a multicentre study

Sentinel lymph node biopsy was attempted in 336 patients with clinically no de-negative cutaneous melanoma. All patients were injected with technetium- 99m labelled radio-colloid, with 108 patients simultaneously receiving vita l blue dye for sentinel node identification. Sentinel lymph nodes were iden tified in 329 patients, giving a technical success rate of 97.9%. Metastati c disease was identified in 39 (11.9%) of the patients in whom sentinel nod es were found. Patients with negative sentinel nodes were observed and pati ents with positive sentinel nodes underwent comprehensive lymph node dissec tion. The presence of metastatic disease in the sentinel nodes and primary tumour depth by Breslow or Clark levels were joint predictors of survival b ased on Cox proportional hazards modelling. Disease recurrences occurred in 26 (8.8%) patients with negative sentinel lymph nodes, with isolated regio nal recurrences as the first site in 10 (3.4%). No patients with Clark leve l II primary tumours were found to have positive sentinel nodes or disease recurrences. One patient with a thin (<0.75 mm) Clark level III primary had metastatic disease in a sentinel node. Patients with metastases confined t o the sentinel nodes had similar survival rates regardless of the number of nodes involved (C) 2001 Lippincott Williams & Wilkins.