Is intraoperative lymphatic mapping and sentinel lymph node biopsy effective and safe in early-stage melanoma?
Marco Gipponi
Correspondence AO Universitaria San Martino, General Surgery, Colo-Rectal Disease Unit, Largo R. Benzi, 8, 16132 Genoa, Italy
Email marco.gipponi@unige.it
This article has no abstract so we have provided the first paragraph of the full text.
The tumor status of regional lymph nodes is the single most important prognostic factor in patients with cutaneous melanoma.1 In the early 1990s, CLND of the regional basin was the only method available to identify regional nodal metastasis, but this approach had two important drawbacks. First, almost 80% of patients undergoing CLND had no lymph node metastasis, so they would have gained no benefit in terms of staging or survival, but were at increased risk for acute and chronic morbidity as a result of the procedure. Second, the pathologic staging of all regional lymph nodes underestimates the true frequency of nodal metastasis by as much as 14% compared with the focused analysis of one or a few SLNs.2, 3 Hence, LM/SLNB has been proposed as a minimally invasive surgical procedure for staging of the regional nodal basin that detects occult metastasis to allow an early therapeutic CLND to be performed.
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