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Purpose of review <p>: This review explores the current state of the sentinel lymph node biopsy (SLNB) in melanoma management, including agents used for SLNB, imaging modalities for localization, special considerations, and novel adjuncts for predicting sentinel node positivity.</p> Recent findings <p>: Technetium-99&#xa0;m Tilmanocept (Lymphoseek) has proven a novel, safe, and effective agent for lymphatic mapping. Melanoma on the trunk, head, and neck regions requires thoughtful operative planning and benefits from preoperative imaging. Planar lymphoscintigraphy and SPECT-CT remain the primary imaging for SLNB. Finally, validated nomograms and gene expression profile (GEP) tests have emerged as promising adjuncts for prognostic and predictive testing and may reduce unnecessary surgery in the future.</p> Summary <p>: The SLNB remains a critical procedure for melanoma management. It provides invaluable information for prognostication, decision-making for adjuvant systemic therapy, surveillance intensity, and clinical trial eligibility and stratification. Success with SLNB requires understanding of the pertinent surgical anatomy, familiarity with the lymphatic mapping process, and diligent interpretation of pertinent imaging.</p>

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The Continued Clinical Relevance of Sentinel Lymph Node Biopsy in Modern Melanoma Management

  • 期刊论文

  • 发表日期：

    2026年3月20日

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  • Kennedy Jensen,
  • James Sun,
  • Elliot A. Asare

摘要

Purpose of review

: This review explores the current state of the sentinel lymph node biopsy (SLNB) in melanoma management, including agents used for SLNB, imaging modalities for localization, special considerations, and novel adjuncts for predicting sentinel node positivity.

Recent findings

: Technetium-99 m Tilmanocept (Lymphoseek) has proven a novel, safe, and effective agent for lymphatic mapping. Melanoma on the trunk, head, and neck regions requires thoughtful operative planning and benefits from preoperative imaging. Planar lymphoscintigraphy and SPECT-CT remain the primary imaging for SLNB. Finally, validated nomograms and gene expression profile (GEP) tests have emerged as promising adjuncts for prognostic and predictive testing and may reduce unnecessary surgery in the future.

Summary

: The SLNB remains a critical procedure for melanoma management. It provides invaluable information for prognostication, decision-making for adjuvant systemic therapy, surveillance intensity, and clinical trial eligibility and stratification. Success with SLNB requires understanding of the pertinent surgical anatomy, familiarity with the lymphatic mapping process, and diligent interpretation of pertinent imaging.