Sentinel Node Biopsy in Melanoma: Technical Considerations of the Procedure As Performed at the John Wayne Cancer Institute

Overview

Journal J Surg Oncol

Specialties General Surgery
Oncology

Date 2010 Jun 1

PMID 20512942

Citations 22

Authors

Sanjay P Bagaria

Mark B Faries

Donald L Morton

Affiliations

Soon will be listed here.

Abstract

Since its first description in 1990, sentinel node (SN) biopsy has become the standard for accurate staging of a melanoma-draining regional lymphatic basin. This minimally invasive, multidisciplinary technique can detect occult metastases by selective sampling and focused pathologic analysis of the first nodes on the afferent lymphatic pathway from a primary cutaneous melanoma. An understanding of preoperative lymphoscintigraphy, intraoperative lymphatic mapping, and the definition of SN are critical for surgical expertise with SN biopsy.

Citing Articles

An Evaluation of Sentinel Lymph Node Biopsy Guideline Adherence in Melanoma.

Van Doren A, Shah H, Ata A, Davis L Ann Surg Oncol. 2025; .

PMID: 39920529 DOI: 10.1245/s10434-025-16971-0.

Patterns in progression from early-stage melanoma to late-stage melanoma: implications for survivorship follow-up.

Savage D, Switzer B, Parikh R, Song J, Stanek C, Arbesman J Melanoma Manag. 2025; 11(1):2424708.

PMID: 39869444 PMC: 11622808. DOI: 10.1080/20450885.2024.2424708.

Tc-Tilmanocept vs. Sulfur Colloid for Sentinel Node Biopsy for Melanoma in the Head and Neck.

Sayal N, Schafer J, Jayne C, Wali A, Lindau R, Sayles H Indian J Surg Oncol. 2024; 15(1):82-87.

PMID: 38511039 PMC: 10948650. DOI: 10.1007/s13193-023-01841-6.

Evaluation of Surgical Aid of Methylene Blue in Addition to Intraoperative Gamma Probe for Sentinel Lymph Node Extirpation in 116 Canine Mast Cell Tumors (2017-2022).

Gariboldi E, Ubiali A, Chiti L, Ferrari R, De Zani D, Zani D Animals (Basel). 2023; 13(11).

PMID: 37889797 PMC: 10251889. DOI: 10.3390/ani13111854.

More than Just Skin-Deep: A Review of Imaging's Role in Guiding CAR T-Cell Therapy for Advanced Melanoma.

Prendergast C, Capaccione K, Lopci E, Das J, Shoushtari A, Yeh R Diagnostics (Basel). 2023; 13(5).

PMID: 36900136 PMC: 10000712. DOI: 10.3390/diagnostics13050992.

References

van Poll D, Thompson J, Colman M, McKinnon J, Saw R, Stretch J . A sentinel node biopsy does not increase the incidence of in-transit metastasis in patients with primary cutaneous melanoma. Ann Surg Oncol. 2005; 12(8):597-608. DOI: 10.1245/ASO.2005.08.012. View

McMasters K, Chao C, Wong S, Wrightson W, Ross M, Reintgen D . Interval sentinel lymph nodes in melanoma. Arch Surg. 2002; 137(5):543-7; discussion 547-9. DOI: 10.1001/archsurg.137.5.543. View

Essner R . The role of lymphoscintigraphy and sentinel node mapping in assessing patient risk in melanoma. Semin Oncol. 1997; 24(1 Suppl 4):S8-10. View

Uren R, Howman-Giles R, Thompson J . Demonstration of second-tier lymph nodes during preoperative lymphoscintigraphy for melanoma: incidence varies with primary tumor site. Ann Surg Oncol. 1998; 5(6):517-21. DOI: 10.1007/BF02303644. View

Cochran A, Balda B, Starz H, Bachter D, Krag D, Cruse C . The Augsburg Consensus. Techniques of lymphatic mapping, sentinel lymphadenectomy, and completion lymphadenectomy in cutaneous malignancies. Cancer. 2000; 89(2):236-41. View

Gibbs J, Huang P, Zhang P, Kraybill W, Cheney R . Accuracy of pathologic techniques for the diagnosis of metastatic melanoma in sentinel lymph nodes. Ann Surg Oncol. 1999; 6(7):699-704. DOI: 10.1007/s10434-999-0691-2. View

Veronesi U, Adamus J, BANDIERA D, Brennhovd O, Caceres E, Cascinelli N . Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities. Cancer. 1982; 49(11):2420-30. DOI: 10.1002/1097-0142(19820601)49:11<2420::aid-cncr2820491133>3.0.co;2-2. View

Faries M, Wanek L, Elashoff D, Wright B, Morton D . Predictors of occult nodal metastasis in patients with thin melanoma. Arch Surg. 2010; 145(2):137-42. PMC: 2880665. DOI: 10.1001/archsurg.2009.271. View

Morton D, Hoon D, Cochran A, Turner R, Essner R, Takeuchi H . Lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: therapeutic utility and implications of nodal microanatomy and molecular staging for improving the accuracy of detection of nodal micrometastases. Ann Surg. 2003; 238(4):538-49. PMC: 1360112. DOI: 10.1097/01.sla.0000086543.45557.cb. View

10.

Morton D, Thompson J, Essner R, Elashoff R, Stern S, Nieweg O . Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial. Multicenter Selective Lymphadenectomy Trial Group. Ann Surg. 1999; 230(4):453-63; discussion 463-5. PMC: 1420894. DOI: 10.1097/00000658-199910000-00001. View

11.

Morton D, Cochran A, Thompson J, Elashoff R, Essner R, Glass E . Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg. 2005; 242(3):302-11. PMC: 1357739. DOI: 10.1097/01.sla.0000181092.50141.fa. View

12.

Sim F, Taylor W, IVINS J, Pritchard D, Soule E . A prospective randomized study of the efficacy of routine elective lymphadenectomy in management of malignant melanoma. Preliminary results. Cancer. 1978; 41(3):948-56. DOI: 10.1002/1097-0142(197803)41:3<948::aid-cncr2820410324>3.0.co;2-z. View

13.

Cochran A, Wen D, Morton D . Occult tumor cells in the lymph nodes of patients with pathological stage I malignant melanoma. An immunohistological study. Am J Surg Pathol. 1988; 12(8):612-8. DOI: 10.1097/00000478-198808000-00002. View

14.

Wright B, Scheri R, Ye X, Faries M, Turner R, Essner R . Importance of sentinel lymph node biopsy in patients with thin melanoma. Arch Surg. 2008; 143(9):892-9. PMC: 2561951. DOI: 10.1001/archsurg.143.9.892. View

15.

Carlson G, Murray D, Lyles R, Hestley A, Cohen C . Sentinel lymph node biopsy in the management of cutaneous head and neck melanoma. Plast Reconstr Surg. 2005; 115(3):721-8. DOI: 10.1097/01.prs.0000152429.06593.c1. View

16.

King T, Fey J, Van Zee K, Heerdt A, Gemignani M, Port E . A prospective analysis of the effect of blue-dye volume on sentinel lymph node mapping success and incidence of allergic reaction in patients with breast cancer. Ann Surg Oncol. 2004; 11(5):535-41. DOI: 10.1245/ASO.2004.10.014. View

17.

Morton D, Thompson J, Cochran A, Mozzillo N, Elashoff R, Essner R . Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med. 2006; 355(13):1307-17. DOI: 10.1056/NEJMoa060992. View

18.

Nieweg O, Tanis P, Kroon B . The definition of a sentinel node. Ann Surg Oncol. 2001; 8(6):538-41. DOI: 10.1007/s10434-001-0538-y. View

19.

Thomas J, Clark M . Selective lymphadenectomy in sentinel node-positive patients may increase the risk of local/in-transit recurrence in malignant melanoma. Eur J Surg Oncol. 2004; 30(6):686-91. DOI: 10.1016/j.ejso.2004.04.004. View

20.

Balch C, Soong S, Atkins M, Buzaid A, Cascinelli N, Coit D . An evidence-based staging system for cutaneous melanoma. CA Cancer J Clin. 2004; 54(3):131-49. DOI: 10.3322/canjclin.54.3.131. View