Sentinel lymph node biopsy

–SLN = First node(s) draining the area of primary lesion.

–Sentinel node biopsy is generally recommended for patients with melanomas at least 1 mm thick or more then 0.75 mm with 1 or more mitoses

–Prognostic factor - data for patient.

–Applying adjuvant therapy.

–Survival benefit.

Sentinel lymph node mapping and biopsy

Adjuvant therapy

– Potential candidates

– Stage IIB )recurrence rate 50%-/+(

– Stage III

–Chemotherapy - not effective (DTIC).

–Immunotherapy - IFN and Ipillimumab

–Vaccination – not effective.

–Clinical trails ( anti BRAF , anti PD1, anti PD1+anti CTLA4- ongoing)