title: Sentinel lymph node biopsy for melanoma: American Society of Clinical Oncology and Society of Surgical Oncology joint clinical practice guideline.
abstract: OBJECTIVE
  The American Society of Clinical Oncology (ASCO) and Society of Surgical Oncology (SSO) sought to provide an evidence-based guideline on the use of lymphatic mapping and sentinel lymph node (SLN) biopsy in staging patients with newly diagnosed melanoma.
  
  
  METHODS
  A comprehensive systematic review of the literature published from January 1990 through August 2011 was completed using MEDLINE and EMBASE. Abstracts from ASCO and SSO annual meetings were included in the evidence review. An Expert Panel was convened to review the evidence and develop guideline recommendations.
  
  
  RESULTS
  Seventy-three studies met full eligibility criteria. The evidence review demonstrated that SLN biopsy is an acceptable method for lymph node staging of most patients with newly diagnosed melanoma.
  
  
  CONCLUSIONS
  SLN biopsy is recommended for patients with intermediate-thickness melanomas (Breslow thickness, 1-4 mm) of any anatomic site; use of SLN biopsy in this population provides accurate staging. Although there are few studies focusing on patients with thick melanomas (T4; Breslow thickness, >4 mm), SLN biopsy may be recommended for staging purposes and to facilitate regional disease control. There is insufficient evidence to support routine SLN biopsy for patients with thin melanomas (T1; Breslow thickness, <1 mm), although it may be considered in selected patients with high-risk features when staging benefits outweigh risks of the procedure. Completion lymph node dissection (CLND) is recommended for all patients with a positive SLN biopsy and achieves good regional disease control. Whether CLND after a positive SLN biopsy improves survival is the subject of the ongoing Multicenter Selective Lymphadenectomy Trial II.
authors: University of Michigan, Ann Arbor, MI, USA.
authors: Sandra L
authors: SL
authors: Wong
authors: Charles M
authors: CM
authors: Balch
authors: Patricia
authors: P
authors: Hurley
authors: Sanjiv S
authors: SS
authors: Agarwala
authors: Timothy J
authors: TJ
authors: Akhurst
authors: Alistair
authors: A
authors: Cochran
authors: Janice N
authors: JN
authors: Cormier
authors: Mark
authors: M
authors: Gorman
authors: Theodore Y
authors: TY
authors: Kim
authors: Kelly M
authors: KM
authors: McMasters
authors: R Dirk
authors: RD
authors: Noyes
authors: Lynn M
authors: LM
authors: Schuchter
authors: Matias E
authors: ME
authors: Valsecchi
authors: Donald L
authors: DL
authors: Weaver
authors: Gary H
authors: GH
authors: Lyman
mesh_terms: D006801:Humans; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000556:secondary* / Q000601:surgery; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy / Q000592:standards*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery