Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Sentinel Lymph Node Biopsy for Melanoma

  • Chapter
  • First Online:
Melanoma

  • 1655 Accesses

Abstract

Intraoperative lymphatic mapping and selective sentinel lymphadenectomy (ILM and SLND) has dramatically altered the surgical management of the regional lymphatics in cutaneous melanoma. Once considered a standard component in the surgical management of patients with cutaneous melanoma, immediate complete lymph node dissection (CLND) or elective lymph node dissection (ELND) is now infrequently performed. Now commonly referred to as “sentinel lymph node biopsy,” ILM and SLND is an operative technique that was developed in order to identify patients with cutaneous melanoma who might benefit from the early detection and surgical management of metastatic disease in the regional lymph nodes while avoiding the significant morbidity of CLND in individuals without regional lymph node metastases and who had little likelihood of benefit from that procedure.

The development of ILM and SLND as a reproducible operative technique to identify metastatic disease in clinically node-negative patients with cutaneous melanoma represents a surgical approach to understanding the underlying mechanism of the metastatic process in cutaneous melanoma. This chapter will highlight the rationale, the history, current status, and future of ILM and SLND.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Norris W. Eight cases of melanosis with pathological and therapeutic remarks on that disease. London: Longman, Brown, Green, Longmans, and Roberts; 1857.

    Google Scholar 

  2. Snow H. Twenty two years’ experience in the treatment of cancerous and other tumours. London: Ballliere, Tindall, and Cox; 1898.

    Google Scholar 

  3. Snow H. Abstract of a lecture on melanotic cancerous disease. Lancet. 1892;2:872–4.

    Google Scholar 

  4. Handley W. The pathology of melanotic growths in the relation to their operative treatment. Lancet. 1907;927(96):1.

    Google Scholar 

  5. Balch CM, Soong SJ, Murad TM, Ingalls AL, Maddox WA. A multifactorial analysis of melanoma: III. Prognostic factors in melanoma patients with lymph node metastases (stage II). Ann Surg. 1981;193:377–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Roses DF, Provet JA, Harris MN, Gumport SL, Dubin N. Prognosis of patients with pathologic stage II cutaneous malignant melanoma. Ann Surg. 1985;201:103–7.

    PubMed  PubMed Central  CAS  Google Scholar 

  7. Callery C, Cochran AJ, Roe DJ, et al. Factors prognostic for survival in patients with malignant melanoma spread to the regional lymph nodes. Ann Surg. 1982;196:69–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Cohen MH, Ketcham AS, Felix EL, et al. Prognostic factors in patients undergoing lymphadenectomy for malignant melanoma. Ann Surg. 1977;186:635–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Morton DL, Wanek L, Nizze JA, Elashoff RM, Wong JH. Improved long-term survival after lymphadenectomy of melanoma metastatic to regional nodes. Analysis of prognostic factors in 1134 patients from the John Wayne cancer clinic. Ann Surg. 1991;214:491–9. discussion 9–501

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Gumport SL, Harris MN. Results of regional lymph node dissection for melanoma. Ann Surg. 1974;179:105–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Davis NC. Cutaneous melanoma. The Queensland experience. Curr Probl Surg. 1976;13:1–63.

    Article  CAS  PubMed  Google Scholar 

  12. Slingluff CL Jr, Stidham KR, Ricci WM, Stanley WE, Seigler HF. Surgical management of regional lymph nodes in patients with melanoma. Experience with 4682 patients. Ann Surg. 1994;219:120–30.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Allen AC, Spitz S. Malignant melanoma; a clinicopathological analysis of the criteria for diagnosis and prognosis. Cancer. 1953;6:1–45.

    Article  CAS  PubMed  Google Scholar 

  14. Lane N, Lattes R, Malm J. Clinicopathological correlations in a series of 117 malignant melanomas of the skin of adults. Cancer. 1958;11:1025–43.

    Article  CAS  PubMed  Google Scholar 

  15. Clark WH Jr, From L, Bernardino EA, Mihm MC. The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res. 1969;29:705–27.

    PubMed  Google Scholar 

  16. Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg. 1970;172:902–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Urist MM, Balch CM, Soong SJ, et al. Head and neck melanoma in 534 clinical Stage I patients. A prognostic factors analysis and results of surgical treatment. Ann Surg. 1984;200:769–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Balch CM, Murad TM, Soong SJ, Ingalls AL, Halpern NB, Maddox WA. A multifactorial analysis of melanoma: prognostic histopathological features comparing Clark's and Breslow’s staging methods. Ann Surg. 1978;188:732–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Balch CM, Soong S, Ross MI, et al. Long-term results of a multi-institutional randomized trial comparing prognostic factors and surgical results for intermediate thickness melanomas (1.0 to 4.0 mm). Intergroup Melanoma Surgical Trial. Ann Surg Oncol. 2000;7:87–97.

    Article  CAS  PubMed  Google Scholar 

  20. Cascinelli N, Morabito A, Santinami M, MacKie RM, Belli F. Immediate or delayed dissection of regional nodes in patients with melanoma of the trunk: a randomised trial. WHO Melanoma Programme. Lancet. 1998;351:793–6.

    Article  CAS  PubMed  Google Scholar 

  21. Sim FH, Taylor WF, Ivins JC, Pritchard DJ, Soule EH. A prospective randomized study of the efficacy of routine elective lymphadenectomy in management of malignant melanoma. Preliminary results. Cancer. 1978;41:948–56.

    Article  CAS  PubMed  Google Scholar 

  22. Veronesi U, Adamus J, Bandiera DC, et al. Inefficacy of immediate node dissection in stage 1 melanoma of the limbs. N Engl J Med. 1977;297:627–30.

    Article  CAS  PubMed  Google Scholar 

  23. Balch CM, Soong SJ, Bartolucci AA, et al. Efficacy of an elective regional lymph node dissection of 1 to 4 mm thick melanomas for patients 60 years of age and younger. Ann Surg. 1996;224:255–63. discussion 63–6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Kinmonth J. The lymphatics. Diseases, lymphography, and surgery. Baltimore: Williams & Wilkins; 1972.

    Google Scholar 

  25. Crispen JF, Jeffries PF. Lymphangiography: a simple method of dye infusion. JAMA. 1962;182:872–3.

    Article  CAS  PubMed  Google Scholar 

  26. Widschwendter P, Friedl TW, Schwentner L, et al. The influence of obesity on survival in early, high-risk breast cancer: results from the randomized SUCCESS A trial. Breast Cancer Res. 2015;17:129.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Wong JH, Cagle LA, Morton DL. Lymphatic drainage of skin to a sentinel lymph node in a feline model. Ann Surg. 1991;214:637–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Holmes EC, Moseley HS, Morton DL, Clark W, Robinson D, Urist MM. A rational approach to the surgical management of melanoma. Ann Surg. 1977;186:481–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127:392–9.

    Article  CAS  PubMed  Google Scholar 

  30. Krag DN, Meijer SJ, Weaver DL, et al. Minimal-access surgery for staging of malignant melanoma. Arch Surg. 1995;130:654–8. discussion 9–60

    Article  CAS  PubMed  Google Scholar 

  31. Reintgen D, Cruse CW, Wells K, et al. The orderly progression of melanoma nodal metastases. Ann Surg. 1994;220:759–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Ross M, Reintgen D, Balch CM. Selective lymphadenctomy. Emerging role of lymphatic mapping and sentinel node biopsy in the management of early stage melannoma. Semin Surg Oncol. 1993;9:219–23.

    PubMed  CAS  Google Scholar 

  33. Thompson JF, McCarthy WH, Bosch CM, et al. Sentinel lymph node status as an indicator of the presence of metastatic melanoma in regional lymph nodes. Melanoma Res. 1995;5:255–60.

    Article  CAS  PubMed  Google Scholar 

  34. Karakousis CP, Velez AF, Spellman JE Jr, Scarozza J. The technique of sentinel node biopsy. Eur J Surg Oncol. 1996;22:271–5.

    Article  CAS  PubMed  Google Scholar 

  35. Alex JC, Weaver DL, Fairbank JT, Rankin BS, Krag DN. Gamma-probe-guided lymph node localization in malignant melanoma. Surg Oncol. 1993;2:303–8.

    Article  CAS  PubMed  Google Scholar 

  36. Albertini JJ, Cruse CW, Rapaport D, et al. Intraoperative radio-lympho-scintigraphy improves sentinel lymph node identification for patients with melanoma. Ann Surg. 1996;223:217–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Van der Velde-Zimmermann D, Roijers JF, Bouwens-Rombouts A, et al. Molecular test for the detection of tumor cells in blood and sentinel nodes of melanoma patients. Am J Pathol. 1996;149:759–64.

    PubMed  PubMed Central  Google Scholar 

  38. Wang X, Heller R, VanVoorhis N, et al. Detection of submicroscopic lymph node metastases with polymerase chain reaction in patients with malignant melanoma. Ann Surg. 1994;220:768–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Nicholl MB, Elashoff D, Takeuchi H, Morton DL, Hoon DS. Molecular upstaging based on paraffin-embedded sentinel lymph nodes: ten-year follow-up confirms prognostic utility in melanoma patients. Ann Surg. 2011;253:116–22.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Lee DY, Lau BJ, Huynh KT, et al. Impact of completion lymph node dissection on patients with positive sentinel lymph node biopsy in melanoma. J Am Coll Surg. 2016;223:9–18.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Morton DL, Thompson JF, Cochran AJ, et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med. 2006;355:1307–17.

    Article  CAS  PubMed  Google Scholar 

  42. Morton DL, Thompson JF, Cochran AJ, et al. Final trial report of sentinel-node biopsy versus nodal observation in melanoma. N Engl J Med. 2014;370:599–609.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Thomas JM, Patocskai EJ. The argument against sentinel node biopsy for malignant melanoma: its use should be confined to patients in clinical trials. Br Med J. 2000;321:3–4.

    Article  CAS  Google Scholar 

  44. Gershenwald JE, Thompson W, Mansfield PF, et al. Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients. J Clin Oncol. 1999;17:976–83.

    Article  CAS  PubMed  Google Scholar 

  45. Jansen L, Nieweg OE, Peterse JL, Hoefnagel CA, Olmos RA, Kroon BB. Reliability of sentinel lymph node biopsy for staging melanoma. Br J Surg. 2000;87:484–9.

    Article  CAS  PubMed  Google Scholar 

  46. McMasters KM, Egger ME, Edwards MJ, et al. Final results of the Sunbelt Melanoma Trial: a multi-institutional prospective randomized phase III study evaluating the role of adjuvant high-dose interferon alfa-2b and completion lymph node dissection for patients staged by sentinel lymph node biopsy. J Clin Oncol. 2016;34:1079–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Kirkwood JM, Strawderman MH, Ernstoff MS, Smith TJ, Borden EC, Blum RH. Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684. J Clin Oncol. 1996;14:7–17.

    Article  CAS  PubMed  Google Scholar 

  48. Scoggins CR, Ross MI, Reintgen DS, et al. Prospective multi-institutional study of reverse transcriptase polymerase chain reaction for molecular staging of melanoma. J Clin Oncol. 2006;24:2849–57.

    Article  CAS  PubMed  Google Scholar 

  49. Morton DL, Thompson JF, Essner R, et al. 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;230:453–63. discussion 63–5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Multicenter Selective Lymphadenectomy Trial II (MSLT-II). 2006. https://clinicaltrials.gov/ct2/show/NCT00297895. Accessed 18 Mar 2017

  51. Faries MB, Thompson JF, Cochran AJ, et al. Completion dissection or observation for sentinel-node metastasis in melanoma. N Engl J Med. 2017;376:2211–22.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Cochran AJ, Morton DL, Stern S, Lana AMA, Essner R, Wen D-R. Sentinel lymph nodes show profound downregulation of antigen-presenting cells of the paracortex: implications for tumor biology and treatment. Mod Pathol. 2001;14:604–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, East Carolina University Brody School of Medicine, Greenville, NC, USA

    Ann Y. Chung M.D., Catalina Mosquera M.D. & Jan H. Wong M.D.

Authors
  1. Ann Y. Chung M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Catalina Mosquera M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan H. Wong M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jan H. Wong M.D. .

Editor information

Editors and Affiliations

  1. Louisiana State University, New Orleans, Louisiana, USA

    Adam I. Riker

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chung, A.Y., Mosquera, C., Wong, J.H. (2018). Sentinel Lymph Node Biopsy for Melanoma. In: Riker, A. (eds) Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-78310-9_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-78310-9_25

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-78309-3

  • Online ISBN: 978-3-319-78310-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation