Sentinel node biopsy in cutaneous melanoma. Our personal experience in ten years of activity (1999-2008)

Cutaneous melanoma represents a malignant neoplasia with incidence that still doubles every ten years for unknown causes. The primary treatment was and remains up today fundamentally surgical in the I and II stadium (as AJCC classification). It consists according to the thickness in the radicalization to two centimetres around the lesion and in the search of the lymph node sentinel (LS). The concept of LS has been developed from Morton et al. and was established in 1990 after having shown that the combination of the preoperatory lymphoscintigraphic study with the use of a vital dye allows with high reliability and precision the individualization and therefore the removal of the LS, defined such the lymph node that drains a defined cutaneous area and therefore is the first structure met by the neoplastic cells. Since it seems that, in the majority of the cases, at least as it regards the initial stadiums of the illness, initially the neoplasia spreads for by lymphatic it is the LS the first one to be involved in the case of lymphatic metastases, therefore its negativity deposes for the negativity of the Whole lymphatic station. Therefore the biopsy of the LS solves the problem of the preventive lymphoadenectomy rather than waiting for some evidence of lymphnode metastasis. KEY WORDS: cutaneous melanoma, sentinel lymph node