Sentinel Lymph Node Biopsy in Melanoma: Who and When? A Literature Review

Abstract

Melanoma is the mostdeadly form of skin cancer globally and causes considerable morbidity if not detected early. Sentinel lymph node biopsy (SLNBx) is an important staging technique used to guide prognosis and therapy; however, its application in thin and thick melanomas remains controversial. This review examines evidence from studies identified through PubMed, Cochrane Review, and Google Scholar that address SLNBx techniques, outcomes, and indications. The findings indicate that SLNBx should be considered standard practice for intermediate-thickness melanomas (1.0–4.0 mm). In thin melanomas (<1.0 mm), it should be used selectively in patients with high-risk pathological features, while in thick melanomas (>4.0 mm), it provides staging value, although its impact on survival remains unclear. The MSLT-I trial demonstrated improved disease-free survival with early nodal treatment in sentinel node–positive patients with intermediate-thickness melanoma. In conclusion, SLNBx is a valuable tool in melanoma management and should be applied based on tumor thickness and associated risk factors.