ABSTRACT
The clinical management of patients with cutaneous melanoma has been revolutionized by the development of sentinel lymph-node mapping. This procedure allows the surgeon to accurately stage the regional lymph node basin by excising the first draining, or “sentinel,” lymph node from a cutaneous melanoma and submitting it for careful pathologic examination. The status of the sentinel lymph node (SLN) has been shown to be the most accurate predictor of prognosis in clinical Stage I and II melanoma patients.1 Those with evidence of metastasis in the SLN (positive SLN) undergo a staging evaluation and completion lymph-node dissection, while patients without metastasis (negative SLN) require no additional operative therapy. In addition, this highly accurate and minimally invasive procedure allows the surgeon to identify patients who may benefit from adjuvant therapy. While it is too early to determine whether the use of SLN mapping will improve the survival experience of patients with melanoma, the published experience using this technique has helped define and reserve its role in the management of patients with the disease.
