Sentinel node biopsy in malignant melanoma

Extirpation of the sentinel lymph node, often termed sentinel lymph node biopsy (SLNB), means the targeted extirpation of the tumor-draining lymph nodes after labeling of these nodes by lymph scintigraphy. Since the first description by Morton in 1990, SLNB has developed into a standard procedure for the primary care of thick melanomas in many centers. SLNB reveals clinically occult lymph node metastases (micrometastases). The histopathologic and immunohistochemical detection of micrometastases provides important prognostic information and can be helpful for further surgical and adjuvant treatment decisions. However, SLNB is also controversially discussed, since there is no evidence that SLNB improves the prognosis of the melanoma patients. Nevertheless, SLNB is recommended in the current German guidelines for melanoma patients with a tumor thickness of 1 mm or greater and the status of the sentinel node has been integrated into the melanoma classification.