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Sentinel Lymph Node Biopsy for Melanoma: American Society of Clinical Oncology and Society of Surgical Oncology Joint Clinical Practice Guideline

Sandra L. Wong, Charles M. Balch, Patricia Hurley, Sanjiv S. Agarwala, Timothy J. Akhurst, Alistair Cochran, Janice N. Cormier, Mark Gorman, Theodore Y. Kim, Kelly M. McMasters, R. Dirk Noyes, Lynn M. Schuc

American Society of Clinical Oncology 2012

Metastasis to regional nodes is the most important prognostic factor in patients with early-stage melanoma and has been shown to occur in approximately 20% of patients with intermediate-thickness tumors.1,2 As such, it is critically important to identify those patients for whom the expected benefits of resecting regional lymph nodes outweigh the risks of surgical morbidity.

Sentinel lymph node (SLN) biopsy is commonly used by surgeons who treat melanoma in the United States, Canada, Australia, and Western Europe and has been endorsed by the American Joint Committee on Cancer (AJCC) as a valuable staging procedure for patients with melanoma who are at risk of clinically occult nodal metastases. This highly accurate and low-morbidity staging procedure should be used to guide treatment decisions (ie, completion lymph node dissection [CLND] and adjuvant therapy) as well as entry into clinical trials.3

To develop and formalize guideline recommendations for the use of SLN biopsy in oncology practice, the American Society of Clinical Oncology (ASCO) and Society of Surgical Oncology (SSO) convened a joint Expert Panel. This guideline addresses two overarching clinical questions:

What are the indications for SLN biopsy?

What is the role of CLND?

This article represents a brief summary overview of the full guideline.