Sentinel lymph node biopsy in malignant melanoma

doi:10.1136/bmj.39519.646424.BE

BMJ 2008;336:902-903 (26 April), doi:10.1136/bmj.39519.646424.BE

Editorials

Sentinel lymph node biopsy in malignant melanoma

Is unnecessary as clinically important micrometastases can beidentified by ultrasound

The first 150 words of the full text of this article appear below.

When melanoma spreads, it invariably does so by the lymphaticsystem. The first lymph node to be affected is called the sentinelnode, and this node can be identified by injecting dye and aradioactive tracer at the primary tumour site. During sentinellymph node biopsy, the sentinel node is located by a hand held ${gamma}$ probe and confirmed as the sentinel node using blue dye staining;it is then removed for histology. About 80% of patients haveno melanoma in the sentinel node. In the remaining patients,the tumour burden varies from tiny deposits of melanoma in thesubcapsular sinus to complete replacement of several sentinelnodes with extracapsular spread. Patients who are sentinel nodenegative have a better prognosis than those who are sentinelnode positive, and the prognosis worsens as the tumour burdenincreases. But evidence is accumulating that some tiny depositsof melanoma in the sentinel node . . . [Full text of this article]

J Meirion Thomas, consultant surgeon

¹ Royal Marsden Hospital, London SW3 6JJ

meirion@roseway.demon.co.uk

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