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The role of sentinel lymph-node biopsy in the management of cutaneous melanoma.

The use of the sentinel lymph node biopsy (SLNB) procedure has developed from an experimental technique to one that is now widely accepted for carcinoma of the breast and for cutaneous melanoma. The status of the sentinel lymph node strongly correlates with survival in patients with melanoma, and it is used in many centers to determine which patients would benefit from elective lymph node dissection and possible chemotherapy. There is emerging yet still not decisive evidence that, when combined with completion lymphadenectomy, SLNB may prolong survival in patients with metastatic disease; however, controversy continues over the lower limit of defining how large a metastatic tumor deposit must be to be meaningful. In addition, many centers are considering SLNB to help stratify risk in melanocytic lesions of uncertain malignant potential.