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Sentinel Lymph Node Biopsy for Melanoma: Indications and Rationale
Cancer Control, 06/30/09

Phan GQ et al. - SLNB provides important prognostic and staging data with minimal morbidity and can be used to identify regional node-negative patients who would not benefit from a complete nodal dissection. In the authors opinion, SLNB should be performed on most patients (with acceptable surgical and anesthesia risk) who have melanomas with a Breslow depth >= 0.76 mm.

Exclusive Author Commentary
Jonathan S. Zager and Giao Phan, 06/30/09

This article adds to the growing body of literature that supports the use of sentinel node biopsy for melanomas. The SLNB is a staging technique that allows for identification of patients who will (or will not) need more surgery and adjuvant therapy. It has been proven to be the single most independant prognostic factor in terms of overall survival in melanoma patients (Gershenwald JCO 2001). Ongoing trials such as the Multicenter Selective Lymphadenectomy Trial II will hopefully determine those patients with positive sentinel nodes who are at risk for further nodal metastases based on primary tumor properties and SLN burden of disease. It is our opinion that this staging method is safe with limited morbidity and adds important prognostic information for clinicians in treating patients with melanoma and should be used for all aptients who are good surgical candidates with melanomas greater than 0.75 mm thick.

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