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  Vol. 144 No. 5, May 2008 TABLE OF CONTENTS
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COMMENTS AND OPINIONS
Lymphatic Mapping and Sentinel Node Biopsy: The Data Unclouded by Speculation

Alistair J. Cochran, MD; John F. Thompson, MD

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A recent gloomy personal opinion expressed by Kanzler1 contains errors, lacks balance, and is impatiently premature. Sentinel node (SN) biopsy (SNB) is "highly controversial" only for an outspoken minority who stubbornly ignore published data. Patients are best served by even-handed consideration of emerging data on melanoma management.

Twenty percent of patients with intermediate-thickness melanoma ostensibly confined to the primary site develop regional nodal metastases after wide excision. Our research group developed SNB to identify those individuals and demonstrated the accuracy and practicability of lymphoscintigraphy and dye-based lymphatic mapping for pinpointing initial nodes on the lymphatic pathway draining the primary melanoma.2 Careful histologic and immunohistologic analysis demonstrates melanoma in approximately 20% of sentinel nodes (SNs). Unlike evaluation of the primary tumor, evaluation of the SNs identifies the presence rather than the probability of nodal metastases.

A randomized prospective study of 2001 patients with . . . [Full Text of this Article]


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