Sentinel node biopsy: linchpin of melanoma management
Source: Insight Plus, August 2022
FOR patients with high-risk primary cutaneous melanomas, the most important advances in their surgical management in recent decades followed the introduction of sentinel node biopsy (SNB) in the mid-1990s and its subsequent widespread use around the world.
These advances in surgical management have been based primarily on the results of the first and second Multicenter Selective Lymphadenectomy Trials (MSLT-I and MSLT-II). Also relevant has been the publication and implementation of the American Joint Committee on Cancer (AJCC) 8th Edition staging system for cutaneous melanoma.
With solid organ cancers, the surgeon’s aim is to completely remove the primary tumour and adjacent lymph nodes. Pathological staging is based on the pathologist’s assessment of both the primary tumour (determining T stage) and the presence or absence of tumour metastases in draining regional lymph nodes (determining N stage). The final overall stage is determined by a combination of these data.