Sentinel-Node Biopsy in Melanoma

In this issue of the Journal, Morton and colleagues report the largest and most important trial of sentinel-lymph-node biopsy for melanoma conducted to date.1 In the trial, 1269 patients with intermediate-thickness (1.2 to 3.5 mm) melanoma were randomly assigned to immediate sentinel-node biopsy or to observation for clinically detectable (palpable) lymph nodes draining the site of the melanoma. If the biopsy showed microscopical metastases, patients underwent immediate radical lymphadenectomy. In the observation group, lymphadenectomy was performed only after palpable lymph nodes were detected. The trial clearly demonstrates that sentinel-node biopsy provides important prognostic information and identifies patients with nodal metastases . . .