A review of sentinel lymph node biopsy for thin melanoma

Introduction Although there is a lack of established survival benefit of sentinel lymph node biopsy (SLNB), this technique has been increasingly applied in the staging of patients with thin (≤1.00 mm) melanoma (T1Nx), without clear supportive evidence. Methods We review the guidelines and available...

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Bibliographic Details
Published in:Irish journal of medical science 2015-03, Vol.184 (1), p.119-123
Main Authors: Joyce, K. M., McInerney, N. M., Joyce, C. W., Jones, D. M., Hussey, A. J., Donnellan, P., Kerin, M. J., Kelly, J. L., Regan, P. J.
Format: Article
Language:English
Subjects:
Chemotherapy, Adjuvant
Disease Management
Family Medicine
General Practice
Humans
Internal Medicine
Lymphatic Metastasis
Medicine
Medicine & Public Health
Melanoma - drug therapy
Melanoma - secondary
Melanoma - surgery
Neoplasm Staging
Practice Guidelines as Topic
Predictive Value of Tests
Review Article
Sentinel Lymph Node Biopsy
Skin Neoplasms - drug therapy
Skin Neoplasms - pathology
Skin Neoplasms - surgery
Survival Rate
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Summary:Introduction Although there is a lack of established survival benefit of sentinel lymph node biopsy (SLNB), this technique has been increasingly applied in the staging of patients with thin (≤1.00 mm) melanoma (T1Nx), without clear supportive evidence. Methods We review the guidelines and available literature on the indications and rationale for performing SLNB in thin melanoma. Results As a consequence of the paucity of evidence of SLNB in thin melanoma, there is considerable variability in the guidelines. It is difficult to define clinicopathologic factors that reliably predict the presence of nodal metastasis. SLNB does not yet inform management in thin melanoma to improve survival outcome. Conclusion Based on available evidence, high risk patients with melanomas between 0.75 and 1.00 mm may be appropriate candidates to be considered for SLN biopsy after discussing the likelihood of finding evidence of nodal progression, the risks of sentinel node biopsy, and the lack of proven survival benefit from any form of surgical nodal staging.
ISSN:0021-1265
1863-4362
DOI:10.1007/s11845-014-1221-1