Last updated January 11, 2022

Sentinel Lymph Node Biopsy And Management Of Regional Lymph Nodes In Melanoma

Key Recommendations

Thin melanomas:

Routine SLN biopsy is not recommended for patients with melanomas that are T1a (nonulcerated lesions <0.8 mm in Breslow thickness). SLN biopsy may be considered for T1b patients (0.8 to 1.0 mm Breslow thickness or <0.8 mm Breslow thickness with ulceration) after a thorough discussion with the patient of the potential benefits and risks of harm associated with the procedure. ( EB , H , H , )
(Quality of evidence: low to intermediate)
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Intermediate-thickness melanomas:

SLN biopsy is recommended for patients with melanomas that are T2 or T3 (Breslow thickness of >1.0 to 4.0 mm). ( EB , H , H , M )
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Thick melanomas:

SLN biopsy may be recommended for patients with melanomas that are T4 (>4.0 mm in Breslow thickness), after a thorough discussion with the patient of the potential benefits and risks of harm associated with the procedure (EB, B, M)
(Quality of evidence: low to intermediate)
3336

Either CLND or careful observation may be offered to patients with low risk micrometastatic disease, with due consideration of clinicopathological factors. For higher risk patients, careful observation may be offered only after a thorough discussion with patients about the potential risks and benefits of foregoing CLND. (EB, B, S)
(Quality of evidence: intermediate to high)
3336

Recommendation Grading

Overview

Title

Sentinel Lymph Node Biopsy And Management Of Regional Lymph Nodes In Melanoma

Authoring Organizations

Publication Month/Year

December 13, 2017

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

To update the American Society of Clinical Oncology (ASCO)-Society of Surgical Oncology (SSO) guideline for sentinel lymph node (SLN) biopsy in melanoma.

Target Patient Population

Patients with newly diagnosed melanoma without clinical evidence of lymph node involvement.

Target Provider Population

Surgical oncologists, medical oncologists, dermatologists, primary care physicians, pathologists, nuclear medicine specialists

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Laboratory services, Operating and recovery room, Outpatient

Scope

Assessment and screening, Management

Keywords

melanoma, SLN

Source Citation

DOI: 10.1200/JCO.2017.75.7724 Journal of Clinical Oncology 36, no. 4 (February 01, 2018) 399-413.

Supplemental Methodology Resources

Data Supplement, Methodology Supplement