Why perform sentinel-lymph-node biopsy in patients with melanoma?
Steven A Rosenberg About the authorSentinel-lymph-node biopsy (SLNB) has become the standard of care for patients presenting with intermediate-thickness melanoma; however, there is no evidence that this procedure has a positive impact on survival. One study (Morton DL [2006] N Engl J Med 355: 1307–1317) was elegantly designed to determine the impact of SLNB on patient survival. In total, 1,269 patients with melanoma and no clinically palpable lymph nodes were prospectively randomized to receive either observation or SLNB, which if positive, was followed by lymph-node dissection. There was no suggestion of a difference in survival when the two groups were compared (P = 0.58).Many subgroup analyses were performed on these data that had little bearing on this main point. The survival analysis comparing patients with positive sentinel-lymph nodes to patients who recurred with nodal disease is difficult to interpret since it assumes no false-positive analyses of the sentinel nodes and that
