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Sentinel Lymph Node Biopsy and Nodal Surgery

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Melanoma in Clinical Practice

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Abstract

Performing sentinel lymph node biopsy (SLNB) at the time of primary excision confers paramount prognostic value for melanoma of all thickness and is thereby helpful for accurate cancer staging. However, the therapeutic value of SLNB-based management has only been shown in certain subgroups and is thus not uniformly advocated for this indication. Specific guidelines are based on tumor thickness. While regional metastasis traditionally prompted a regional complete lymph node dissection (CLND), more recent prospective trials have found no survival benefit of performing CLND for regional metastasis identified via SLNB. Updated guidelines state that CLND or observation with routine exam and ultrasonography are appropriate options in the management of positive SLNB. Decisions should be patient-centered with thorough consideration of the specific risks and benefits. Additional research is needed to further inform physicians on the optimal surgical management of melanoma, including cases of positive SLNB.

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Authors and Affiliations

  1. Boston University School of Medicine, Boston, MA, USA

    Brendin Beaulieu-Jones & Michael R. Cassidy

  2. Boston Medical Center, Boston, MA, USA

    Brendin Beaulieu-Jones & Michael R. Cassidy

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  1. Brendin Beaulieu-Jones
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  2. Michael R. Cassidy
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Correspondence to Michael R. Cassidy .

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Editors and Affiliations

  1. Department of Dermatology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA

    Rhoda M. Alani

  2. Department of Dermatology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA

    Debjani Sahni

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Beaulieu-Jones, B., Cassidy, M.R. (2021). Sentinel Lymph Node Biopsy and Nodal Surgery. In: Alani, R.M., Sahni, D. (eds) Melanoma in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-82639-0_10

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  • DOI: https://doi.org/10.1007/978-3-030-82639-0_10

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