Sentinel Lymph Node Biopsy And Management Of Regional Lymph Nodes In Melanoma
Publication Date: December 13, 2017
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)
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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)
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Recommendation Grading
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Overview
Title
Sentinel Lymph Node Biopsy And Management Of Regional Lymph Nodes In Melanoma
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