Metastasis of melanoma to regional lymph nodes is readily identified by sentinel lymph node (SLN) biopsy. Sentinel lymph node biopsy in patients with melanoma, while clearly not improving survival in patients with negative SLNs,1 offers other noteworthy advantages that justify the minor increase in morbidity over wide excision alone. These include superior staging and prognostication1,2; improved relapse-free survival, with more patients alive and free from relapse at 5 years postoperatively1; improved regional control and potentially less morbidity compared with node dissection performed because of palpable metastases3; and, perhaps, improved survival in patients with positive SLNs.1 Another underappreciated value of SLN biopsy is enhancement of our understanding of the metastatic process. Available prognostic factors, based on clinical parameters and histologic findings in the primary tumor, are limited in their ability to reliably determine which patients will manifest SLN metastasis or disseminated disease, indicating the presence of missing links in our understanding of how melanomas metastasize.4 There is an unmet clinical need for improved predictive biomarkers of metastasis in clinically localized primary melanomas. These new biomarkers can be derived only from improved understanding of melanoma biology and the inherent variations in the host response to the tumor.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Dermatology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 6
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.