Cancer Treatment Today

NCCN recommends sentinel node biopsy. Similarly, ASCO 2012 recommends: ” SLN biopsy is recommended for patients with intermediate-thickness melanomas (1-4mm Breslow thickness) of any anatomic site; use of SLN biopsy in this population provides accurate staging. While there are few studies focusing on patients with thick melanomas (T4; >4mm Breslow thickness), SLN biopsy may be recommended for staging purposes and to facilitate regional disease control. (This is a T4 melanoma). Completion lymph node dissection (CLND) is recommended for all patients withSimilarly, ASCO 2012 recommends: ” SLN biopsy is recommended for patients with intermediate-thickness melanomas (1-4mm Breslow thickness) of any anatomic site; use of SLN biopsy in this population provides accurate staging. While there are few studies focusing on patients with thick melanomas (T4; >4mm Breslow thickness), SLN biopsy may be recommended for staging purposes and to facilitate regional disease control. There is insufficient evidence to support routine SLN biopsy for patients with thin melanomas (T1; <1mm Breslow thickness), although it may be considered in selected cases with high risk features when staging benefits outweigh risks of the procedure. Completion lymph node dissection (CLND) is recommended for all patients with a positive SLN biopsy and achieves good regional disease control. Whether CLND following a positive SLN biopsy improves survival is the subject of the ongoing Multicenter Selective Lymphadenectomy Trial II.” a positive SLN biopsy and achieves good regional disease control.” However, guidelines do not specifically recommend radio-scintigraphy.

Wong SL, Balch CM, Hurley P, Agarwala SS, Akhurst TJ, Cochran A, Cormier JN, Gorman M, Kim TY, McMasters KM, Noyes RD, Schuchter LM, Valsecchi ME, Weaver DL, Lyman GH. Sentinel lymph node biopsy for melanoma: American Society of Clinical Oncology and Society of Surgical Oncology joint clinical practice guideline. J Clin Oncol. 2012 Aug 10;30(23):2912-8. [98 references]

http://am.asco.org/guidelines-use-sentinel-lymph-node-biopsy-melanoma, 2013