Abstract
Cutaneous melanoma incidence has been increasing last 3 decades. Despite recent improvements in treatments, metastatic disease prognosis remains unfavorable. Lymph node involvement is a major prognosis factor in melanoma, and sentinel lymph node (SLN) biopsy becomes an essential procedure for nodal staging. SLN biopsy is available in most surgical cancer departments but procedure needs very strict achievement guidelines to allow a high level of performance. SLN biopsy could detect a prospective lymph node involvement with very high accuracy, along with very low morbidity. So, lymph node dissection would be performed only in a limited number of patients, increasing their disease free survival. However, in case of positive SLN, lymph node dissection interest as therapeutic act is still under debate and, in the future, indications of lymph node dissections will be purposed more accurately according to prognosis factors, especially histologic SLN analysis. Up to now, adjuvant treatments in melanoma were disappointing but new promising molecules are under research. According to researches results, SLN biopsy will probably allow a better selection of patients who should get benefit of those treatments.
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