Title: Sentinel Lymph Node Biopsy in Melanoma and Other Cutaneous Malignancies | PER
Abstract: Introduction The modern concept of the sentinel lymph node was established in cutaneous melanoma by Morton and his colleagues. They defined a sentinel lymph node as the first lymph node that drains lymph from the site of a primary melanoma. This definition has since been expanded to apply to all cancers that spread by the lymphatic route. Using vital blue dye initially and subsequently adding radioactive colloids, they were able to trace lymphatic flow from the primary tumor site to the sentinel lymph node in a very high percentage of patients, and showed that the status of the sentinel node was predictive of the status of other nodes within that basin as well as strongly correlated with prognosis.2 The use of sentinel lymph node biopsy (SLNB) is restricted to patients with cancers with clinically negative nodes and no evidence of distant metastatic disease, and is performed whenever possible at the time of surgical treatment of the primary tumor rather than afterward. The sentinel lymph node is carefully assessed for the presence of clinically occult disease, using serial sectioning techniques and immunohistochemical analysis that is substantially more extensive than the histopathologic analysis routinely utilized for lymph nodes harvested in a complete lymphadenectomy. If the sentinel lymph node is negative, then the rest of the nodes in the lymphatic basin in question are very likely to be negative. Fundamentally, SLNB is a staging tool that can help determine prognosis. The routine use of SLNB has not been shown to lead to a statistically significant increase in survival in any cancer type, including melanoma.3
Publication Year: 2014
Publication Date: 2014-08-01
Language: en
Type: article
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Cited By Count: 2
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