Sunday, October 8, 2006
10053

Sentinel Node Biopsy for Malignant Melanoma

Walter J. Flapper, BHB, MBChB, Patricia Too, MBBS, and Adam Bialostocki, MBChB.

Since the first description in 1992, sentinel node biopsy for melanoma has been enthusiastically adopted by a number of centres as a minimally invasive method of accurately staging melanoma. Proponents argue that sentinel node biopsy is the most effective method of determining the absence or presence of nodal involvement, and that the histologic status of the sentinel node is a highly significant prognostic factor. However, there are also a number of authors who argue against it's use in routine practice, suggesting it should be reserved for clinical trials only as there is no evidence of any survival advantage for patients with a positive sentinel node biopsy who undergo completion lymphadenectomy. Waikato Hospital was one of the first centres in New Zealand to perform sentinel node biopsies for malignant melanoma. This study reviews 203 sentinel node biopsies that have been carried out for melanoma at Waikato Hospital over a ten-year period between 1994 and 2004. Lymph nodes were obtained in 196 cases. 27 sentinel node biopsies were positive. The rate of sentinel node positivity increased with increasing tumour thickness. This was particularly significant in T4 lesions. The rate of recurrence was higher in patients who were sentinel node biopsy positive.
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