Should all melanoma patients undergo sentinel lymph node biopsy?
OBJECTIVE
It is now well established that sentinel lymph node biopsy is a powerful test to predict prognosis for melanoma patients. Controversy exists, however, regarding the appropriate selection of patients for sentinel lymph node biopsy, especially among patients with thin melanomas (< 1 mm Breslow thickness), thick melanomas (> 4 mm Breslow thickness), or locally recurrent melanoma.


RESULTS
The majority of the studies in the past 2 years regarding sentinel lymph node biopsy have been concerned with identifying factors that can better predict regional nodal metastasis and survival. Other studies have proposed a better risk stratification model, which includes these factors, to best select those patients at increased risk of nodal positivity.


CONCLUSIONS
Although much research has been done to select appropriate patients for sentinel lymph node biopsy based on multiple prognostic factors, further studies are necessary to completely define the indications for this procedure in patients with thin, thick and locally recurrent melanomas.
Ra
Jin Hee
JH
Department of Surgery, Hospital of the University of Pennsylvania, PA 19104, USA.
McMasters
Kelly M
KM
Spitz
Francis R
FR
D006801:Humans; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000601:surgery*