Sentinel node biopsy is a procedure often used in assessing the risk posed by a melanoma. It is a method of surgically sampling the lymph nodes that the melanoma would most likely go to if it has spread. It has generally been believed that the information gained by this procedure could give the most accurate assessment of the patients chances of survival, and so help guide treatment. However a new study from the Cleveland Clinic, suggest that it may not actually add any extra prognostic information beyond the analysis of the original melanoma itself. This study suggests that the Breslow thickness of the melanoma (which is a measure of the thickness of the melanoma the pathologist will determine when analyzing the original specimen), gives as accurate prognostic information without having to go through another surgical procedure with all the risks that may involve. The decision whether or not to undergo a sentinel node biopsy is a complex one. For most early (thin), melanomas there is no benefit at all. However this study suggests that even for other melanomas the information gained may not be as useful as previously thought.
Journal of the American Academy of Dermatology
Prognostic Value of Sentinel Lymph Node Biopsy According to Breslow Thickness for Cutaneous Melanoma
J Am Acad Dermatol 2018 Feb 03;[EPub Ahead of Print], E Stiegel, D Xiong, J Ya, P Funchain, R Isakov, B Gastman, A Vij